The Preoperative Factors Predicting a Positive Frozen Section during Radical Prostatectomy for Prostate Cancer

ABSTRACT

PURPOSE: The purpose of this study was to identify the preoperative factors that predict a positive frozen section during radical prostatectomy for prostate cancer. MATERIALS AND METHODS: We retrospectively analyzed preoperative prostate-specific antigen (PSA), prostate volume, Gleason score, the number or percent (%) of cancer-positive cores from prostate biopsy, and the clinical stage of 364 patients who underwent radical prostatectomy between 1993 and 2007. We compared these parameters between patients who had positive frozen sections in specimens from the urethra or bladder neck with those who had negative frozen sections. RESULTS: The PSA and Gleason score were significantly higher and prostate volume was significantly smaller in patients with positive frozen sections in the urethra than in patients with negative frozen sections. The results were the same for the bladder neck. In multivariate analysis, PSA was the only independent predictor for positive frozen sections at the bladder neck, and the cutoff value was 8.71 ng/ml. CONCLUSIONS: Preoperative PSA may be a potent factor for predicting positive frozen sections during radical prostatectomy, especially in the bladder neck. Therefore, it may be beneficial to prepare frozen sections of the bladder neck during the operation to reduce the positive resection margin when PSA is higher than 8.7 ng/ml.