Prediction of outcomes after radical prostatectomy in patients diagnosed with prostate cancer of biopsy gleason score ≥ 8 via contemporary multi(≥12)-core prostate biopsy

OBJECTIVE To investigate the outcome of patients who underwent radical prostatectomy (RP) for prostate cancer of biopsy Gleason score >= 8 diagnosed via contemporary prostate biopsy. PATIENTS AND METHODS We reviewed records of 151 patients who underwent RP for prostate cancer of biopsy Gleason score >= 8 detected via multi (>= 12)-core prostate biopsy without any neoadjuvant or adjuvant treatment. Preoperative predictors of pathologically organ-confined disease along with biochemical recurrence-free survival were analyzed via multivariate logistic regression and Cox proportional hazards model. RESULTS For 151 total subjects, 5-year estimated biochemical recurrence-free survival rate was 41.0%. Patients with pathologically organ-confined disease were observed to have much higher 5-year biochemical recurrence-free survival rate than those otherwise (72.1 vs 31.5%, P < 0.001). Serum PSA level (P = 0.031) and maximum tumour length in a biopsy core (P = 0.005) were observed to be significant preoperative predictors of having pathologically organ-confined disease. As for biochemical recurrence-free survival following RP, serum PSA (P = 0.023), biopsy Gleason score (P = 0.032), and percent of total tumour length in biopsy cores (P < 0.001) were observed be significant preoperative predictors on multivariate analysis. CONCLUSION Among contemporary patients with biopsy Gleason score >= 8 who underwent RP alone, patients with pathologically organ-confined disease demonstrated significantly better biochemical outcome than others. Serum PSA level and maximum tumour length in a biopsy core, independent predictors of organ-confined disease, would be useful in the selection of candidates for RP among patients presenting with biopsy Gleason score >= 8.