Single focus of adenocarcinoma in the prostate biopsy specimen is not predictive of the pathological stage.

Is the percentage of cancer in biopsy cores predictive of extracapsular disease in T1-T2 prostate carcinoma?

Single focus of adenocarcinoma in the prostate biopsy specimen is not predictive of the pathological stage.

Brace RG, Rankin WR, Cibull ML, Rayens MK, Banks ER and Wood DP.
Urology 1996, 48: 75-79.


This paper attempts to determine the importance of small foci (less than 2 mm in length) of prostatic cancer in needle biopsy specimens. 49 (8%) patients with a microscopic focus confined to a single core specimen were identified from a retrospective review of 598 needle biopsies of the prostate. Twenty seven of these 49 subsequently under went radical prostatectomy with or without pelvic lymph node dissection (26) or lymph node adenectomy (1). Of these 27 patients, 7 had extra-prostatic spread. Of the remaining 22 treated either by radiotherapy or hormonal manipulation, 3 patients had bone metastasis at diagnosis, and two patients treated by radiotherapy suffered relapse within 1 year. Thus 12 of the 49 had unfavourable disease at presentation. Whereas other studies have suggested that the volume of tumour within a needle biopsy may correlate with the total volume of tumour and incidence of extraprostatic disease, this paper shows that a small amount of cancer in a needle biopsy cannot be taken to indicate clinically insignificant malignancy.

Is the percentage of cancer in biopsy cores predictive of extracapsular disease in T1-T2 prostate carcinoma?

Ravery V, Schmid HP, Toublanc M, Boccon-Gibod L.
Cancer 1996, 78: 1079-1084.

This retrospective study evaluated the percentage of biopsy core involvement by tumour and its relationship to
PSA progression and presence of extra-prostatic extension in the surgical specimen following radical
prostatectomy. Cores were obtained in the majority by transrectal ultrasound guided biopsy although some were
from transurethral resection of the prostate. If more than 10% by volume of biopsy cores were cancer, PSA
failure was more likely as judged by Kaplan Meier analysis, but the differences were not large. The clinical
importance of percentage of biopsy core positive cancer is still equivocal.