Login to Access Video or Poster Abstract: MP77-07
Sources of Funding: none

Introduction

Apex prostate cancer is an important prognostic factor related to the biochemical recurrence after a radical prostatectomy. In this study, we have taken a biopsy of additional two cores of both prostate apex anterior along with the 12-routine cores. We evaluated a pathological aggressiveness of the additional both apex anterior cores and compared it to the 12-routine cores.

Methods

Patients who underwent 14-core prostate biopsy including 2-additional cores of prostate apex anterior for elevated prostate specific antigen from May 2014 to May 2016 were enrolled in this study, prospectively. Those who have had a previous biopsy history or a palpable nodule on the digital rectum examination were excluded. A total of 194 patients clinical data were collected which includes age, prostate specific antigen, prostate volume measured by transrectal ultrasonography, pathological data of prostate cancer including Gleason score, cancer length of core, and the percentage of cancer.

Results

Cancer detection rate of the 14-core prostate biopsy was 46.6% (91/194). In terms of prostate biopsy specimen, the cancer detection rate of 12-routine cores was higher than additional 2-cores, but was not significant (19.1% (446/2338) vs 15.4% (60/390), p=0.083). The Gleason score of cancer with 12-routine cores was more aggressive than 2-additional cores (table2, p=0.04). The percent of cancer in cancer cores of 12-routine cores was higher than that of 2-additional cores. (table2, p=0.04). Only 3 patients were diagnosed with prostate cancer through 2-additional cores out of 14-cores, all of the patients had 1 cancer core with a Gleason score of 6. 3 patients underwent upgrading of Gleason score by 2-additional cores with 1 Gleason score point.

Conclusions

There were few patients who had prostate cancer only in anterior apex cores. In apex anterior cores, incidence of cancer was lower than the other cores and pathological feature was similar or indolent. Additional cores of apex anterior was not most aggressive feature to determine the treatment method of patients.

Funding

none