Lendínez-Cano G, Alonso-Flores J, Beltrán-Aguilar V, Cayuela A, Salazar-Otero S, Bachiller-Burgos J
Servicio de Urología, Consorcio Sanitario Público Aljarafe, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España.
Servicio de Urología, Consorcio Sanitario Público Aljarafe, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España.
Actas Urol Esp. 2015 Oct;39(8):482-7. doi: 10.1016/j.acuro.2015.02.005. Epub 2015 Apr 18.
To analyze the correlation between pathological data found in radical prostatectomy and previously performed biopsy in patients at low risk prostate cancer.
A descriptive, cross-sectional study was conducted to assess the characteristics of radical prostatectomies performed in our center from January 2012 to November 2014. The inclusion criteria were patients with low-risk disease (cT1c-T2a, PSA≤10ng/mL and Gleason score≤6). We excluded patients who had fewer than 8 cores in the biopsy, an unspecified number of affected cores, rectal examinations not reported in the medical history or biopsies performed in another center.
Of the 184 patients who underwent prostatectomy during this period, 87 met the inclusion criteria, and 26 of these had<3 affected cores and PSA density≤.15 (very low risk). In the entire sample, the percentage of undergrading (Gleason score≥7) and extracapsular invasion (pT3) was 18.4% (95% CI 10.3-27.6) and 10.35% (95% CI 4.6-17.2), respectively. The percentage of positive margins was 21.8% (95% CI 12.6-29.9). In the very low-risk group, we found no cases of extracapsular invasion and only 1 case of undergrading (Gleason 7 [3+4]), representing 3.8% of the total (95% CI 0-12.5). Predictors of no correlation (stage≥pT3a or undergrading) were the initial risk group, volume, PSA density and affected cores.
Prostate volume, PSA density, the number of affected cores and the patient's initial risk group influence the poor pathological prognosis in the radical prostatectomy specimen (extracapsular invasion and Gleason score≥7).
分析低危前列腺癌患者根治性前列腺切除术中发现的病理数据与之前进行的活检之间的相关性。
进行了一项描述性横断面研究，以评估2012年1月至2014年11月在本中心进行的根治性前列腺切除术的特征。纳入标准为低危疾病患者（cT1c - T2a，PSA≤10ng/mL且Gleason评分≤6）。我们排除了活检组织芯少于8个、受累组织芯数量未明确、病史中未报告直肠检查或在其他中心进行活检的患者。
在此期间接受前列腺切除术的184例患者中，87例符合纳入标准，其中26例受累组织芯<3个且PSA密度≤0.15（极低危）。在整个样本中，分级过低（Gleason评分≥7）和包膜外侵犯（pT3）的百分比分别为18.4%（95%可信区间10.3 - 27.6）和10.35%（95%可信区间4.6 - 17.2）。切缘阳性的百分比为21.8%（95%可信区间12.6 - 29.9）。在极低危组中，未发现包膜外侵犯病例，仅1例分级过低（Gleason 7 [3 + 4]），占总数的3.8%（95%可信区间0 - 12.5）。无相关性（分期≥pT3a或分级过低）的预测因素为初始风险组、体积、PSA密度和受累组织芯。
前列腺体积、PSA密度、受累组织芯数量和患者的初始风险组会影响根治性前列腺切除标本的不良病理预后（包膜外侵犯和Gleason评分≥7）。
