Pathologic features from prostate needle biopsy and prognosis after I-125 brachytherapy
Article first published online: 7 DEC 1998
Copyright © 1998 Wiley-Liss, Inc.
Radiation Oncology Investigations
Volume 6, Issue 4, pages 170–174, 1998
How to Cite
Grann, A., Gaudin, P. B., Raben, A. and Wallner, K. (1998), Pathologic features from prostate needle biopsy and prognosis after I-125 brachytherapy. Radiat. Oncol. Investig., 6: 170–174. doi: 10.1002/(SICI)1520-6823(1998)6:4<170::AID-ROI4>3.0.CO;2-V
- Issue published online: 7 DEC 1998
- Article first published online: 7 DEC 1998
- Manuscript Accepted: 19 MAR 1998
- Manuscript Revised: 18 MAR 1998
- Manuscript Received: 12 JAN 1998
- prostatic carcinoma;
- Gleason score;
- perineural invasion
To evaluate the role of detailed pathologic features in predicting outcome for early-stage prostate cancer treated with I-125 brachytherapy. The pretreatment biopsy slides of 103 patients with T1/T2 and Gleason scores of 4–7 prostatic carcinoma, which was treated by transperineal I-125 implantation, were reviewed retrospectively by a single pathologist (P.B.G.). Biochemical tumor control rates [prostate-specific antigen (PSA) below 1.0] were correlated with pretreatment PSA, Gleason score, the amount of tumor in the biopsy samples, and the presence of perineural invasion.In Cox proportional-hazard, multivariate analysis, the strongest predictors of failure were pretreatment PSA above 10 ng/ml (P = 0.013) and the length of the biopsy specimen replaced by tumor (P = 0.15). The percent of biopsy tissue replaced by tumor (P = 0. 74), perineural invasion (P = 0.78), and Gleason score (P = 0.66) were less predictive of prognosis. It was concluded that pretreatment PSA is the strongest predictor of biochemical failure. Detailed assessment of pathological features on needle biopsy added little prognostic information beyond that of pretreatment PSA alone. Like all other prognostic parameters for prostate cancer, there is considerable overlap in pathologic features between those patients who will or will not be controlled biochemically. Radiat. Oncol. Invest. 6:170–174, 1998. © 1998 Wiley-Liss, Inc.