Prediction of extracapsular extension of prostate cancer based on systematic core biopsies

Objective. To evaluate the clinical utility of transrectal ultrasound-guided systematic sextant or octant biopsies for the prediction of extracapsular extension (ECE) at radical prostatectomy. Material and methods. We performed a retrospective analysis of 84 patients who underwent preoperative staging and transrectal ultrasound-guided systematic sextant (n=60) or octant (n=24) biopsy. The presence of ECE was correlated with the number of positive biopsies on each side of the prostate by χ2 analysis. Sensitivity, specificity and positive and negative predictive values were calculated for both positive (two or three positive biopsies per side) and negative (none or one positive biopsy per side) test results. The number of positive cores was thereafter combined with two other parameters: prostate-specific antigen (PSA) level and Gleason score. Results. ECE was evidenced at radical prostatectomy in 24% of patients (20/84). χ2 analysis demonstrated a significant correlation between the number of positive biops...