Distribution of clinically significant small cancer of the prostate in radical prostatectomy specimens

BACKGROUND: In patients with prostate cancel, radical prostatectomy specimen frequently exhibits non-organ confined disease. We should detect clinically significant small cancer to cure the patients, because tumor volume is one of factors with respect to progression of prostate cancer. The distribution of clinically significant small cancer foci of the prostate was studied to determine an adequate sampling portion in needle biopsy using the maps of radical prostatectomy specimens. MATERIALS AND METHODS: Thirty-seven cases with less than 1.5 cc tumor volume in the main cancer focus who underwent radical prostatectomy were pathologically evaluated using step-sectioned specimens. RESULTS: Seventy three clinically significant cancer foci with less than 1.5 cc tumor volume were recognized. Forty six of 73 foci (63.0%) existed only in the lateral aspect of the prostate compared to 14 foci (19.2%) only in the mid-lobe aspect. The remaining 13 foci (17.8%) existed in both aspects. Moreover, 53 of 73 foci (72.6%) were detected in lateral aspect of the middle and apex of the prostate. CONCLUSION: Systematic biopsy including sampling of lateral aspect in the apex and middle portion of the prostate may improve the detection of clinically significant cancer with small tumor volume.