Urology Journal

Abstract

Purpose: To evaluate the epidemiological, clinical and pathological parameters that may predict
the presence of positive surgical margins and extraprostatic disease in patients with low risk [prostate
specific antigen (PSA) < 10, and Gleason score ≤ 6, stage T1c)] prostate cancer.
Materials and Methods: We retrospectively analyzed the medical records of patients who had
undergone radical prostatectomy from January 2005 until January 2011. The analysis comprised
patients’ age, preoperative serum prostate specific antigen (PSA) level, prostate volume, PSA density,
biopsy Gleason score, the presence of bilateral disease according to the results of biopsy cores
analysis, the percentage of cancer in biopsy material and the presence of high grade prostatic intraepithelial
neoplasia.
Results: A total of 117 patients were included in the study. Positive surgical margins were found in
37 (31.6%) patients and 23 (19.7%) had advanced disease. The results of the multivariate analysis
showed that bilateral disease was the single significant predictor for advanced disease prediction
(P = .04). Same results was obtained by the univariate analysis of the variables for prediction of
positive surgical margins, where bilateral disease after biopsy cores analysis was the only factor to
be statistical significant (P = .018).
Conclusion: Bilateral prostate cancer in prostate biopsy is significantly associated with positive
surgical margins and advanced disease in patients that are operated for prostate cancer of low risk.
This observation may assist the selection of patients in whom a bilateral nerve sparing radical prostatectomy
is planned to be performed.