Does Laterality of Positive Needle Biopsy in Clinical T2a Patients With Prostate Cancer Affect Biochemical Recurrence-Free Survival?

Objectives: To test whether patients with clinical Stage T2a prostate cancer with biopsy-proven disease only contralateral to the palpable abnormality experience outcomes similar to those of patients with clinical Stage T1c. Methods: We identified 1567 patients who had undergone radical prostatectomy at our institution from 1995 to 2007 with a prostate-specific antigen level of less than 10 ng/mL and complete information regarding the laterality of positive biopsy cores. Of these patients, 1157 had clinical Stage T1c and 410 Stage cT2a. The patients with clinical Stage T2a were divided into two groups according to the laterality of the positive biopsy cores: ipsilateral only (n = 241) and contralateral only (n = 53). Kaplan-Meier analyses were used to compare the biochemical recurrence-free survival (BRFS) probabilities. Results: The patients with clinical Stage T2a had significantly poorer 5-year BRFS than did the patients with clinical Stage T1c (83.5% versus 94.4%, P <0.001). The difference in BRFS between the contralateral and ipsilateral clinical Stage T2a groups was statistically insignificant. A significant difference was found in BRFS between patients with cT1c and cT2a ipsilateral disease. A statistically insignificant difference in BRFS was found between patients with cT1c and cT2a contralateral disease. Conclusions: The laterality of the needle biopsy in relation to the palpable abnormality in patients with clinical Stage T2a could affect BRFS. Our data have demonstrate an insignificant difference between patients with cT2a contralateral disease and those with contralateral cT1c disease.