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To investigate the significance of the percentage of positive biopsy cores (PPBCs) in predicting the biochem- ical outcome in patients with clinically localised prostate cancer undergoing low-dose rate brachytherapy (LDRB).  A total of 326 consecutive patients underwent LDRB between February 1997 and January 2007. The cohort consisted of 68.7%, 30.4% and 0.9% of low-, intermediate- and high-risk groups respectively as defined by the D'Amico classifica- tion. Patients were stratified according to PPBCs ( 50%).  Of the 326 men, 316 (97%) met the study criteria and were included in the analysis. The median follow-up was 66.3 (12.9-147.5) months. Thirty-eight men (12%) developed evidence of biochemical relapse as defined by the Phoenix defi- nition at a median of 44.5 (4-133) months. The overall 5-year and 10-year biochemical relapse-free rate (BRFR) was 91.9% (95% CI 87.9% to 94.6%) and 76.9% (95% CI 66% to 84%) respectively.  On univariate analysis, Gleason score (p=0.03), D'Amico risk groups (p=0.004) and PPBCs (p=0.001) were significant predictors of biochemical failure. In the multivariate model, the PPBCs (p=0.0006) and pretreatment PSA (p=0.004) were the only variables that predicted for biochemical failure. The 5-year biochemical relapse-free rate was 93.5%, 93.0% and 76.5% for the PPBCs 50% respectively (p=0.001). Conclusions:  The PPBC is an important independent predictor of the 5-year biochemical relapse-free survival after LDRB. This finding suggests that patients with high volume tumour are at increased risk of biochemical failure with LDRB.

the open prostate cancer journal

Impact of Percentage of Positive Biopsy Cores on Biochemical Outcome in Patients Treated With Low-Dose Rate (Iodine-125) Brachytherapy for Prostate Cancer