Gross Lesion Spatial Distribution of Prostate Cancer Confirmed by Transperineal Prostate Biopsy

  Objective  To demonstrate the gross lesion spatial distribution of prostate cancer confirmed by template-guided transperineal prostate biopsy (TTPB).

  Methods  This study enrolled 61 consecutive patients diagnosed as prostate cancer with no more than 6 positive regions on TTPB between November 2013 and March 2015 in Peking Union Medical College Hospital. With radical prostatectomy specimens from these patients, we compared the tumor frequencies and characteristics on anterior and posterior zones in gross pathology. The lesion spatial distributions were further compared among apex, middle, and base of prostate.

  Results  Of the 61 predominant tumors, the anterior (APCs) and posterior prostate cancers (PPCs) were 32 (52.5%) and 29 (47.5%), with no significant difference (χ²=0.295, P=0.587). There was no difference in positive surgical margin or Gleason score (GS) between APCs and PPCs. The tumor frequencies of apex, middle, and base of prostate were 96.7%, 80.3%, and 29.5%, respectively; the tumor loads per unit volume were 105.17, 130.62, and 69.81 μl/ml, respectively. Compared with the base, the apex had a higher tumor frequency (χ²=31.816, P < 0.001) and tumor load (P=0.028).

  Conclusions  The tumor frequencies and pathological characteristics observed in gross pathology of the anterior and posterior zones of whole-mounted radical prostatectomy specimens may be similar in TTPB-confirmed prostate cancer. Compared with the base of prostate, the apex may be associated with a higher tumor frequency and tumor load.