TY  - EJOU
AU  - Porcaro, Antonio Benito 
AU  - Cerruto, Maria Angela 
AU  - Bianchi, Alberto 
AU  - Artoni, Francesco 
AU  - Montanaro, Francesca 
AU  - Baielli, Alberto 
AU  - Caudana, Filippo 
AU  - Franceschini, Andrea 
AU  - Veccia, Alessandro 
AU  - Rizzetto, Riccardo 
AU  - Brunelli, Matteo 
AU  - Bertolo, Riccardo Giuseppe 
AU  - Antonelli, Alessandro 

TI  - Index density of positive biopsy cores is associated with post-robotic cancer progression
T2  - Canadian Journal of Urology

PY  - 
VL  - 
IS  - 
SN  - 1488-5581

AB  -  <b>Background:</b> Current prognostic stratification of prostate cancer (PCa) does not fully capture disease heterogeneity. Common biopsy-based parameters, such as the percentage of biopsy positive cores (BPC), do not account for prostate volume (PV). This study aims to evaluate the association between the index density of biopsy positive cores (Id-BPC), defined as the ratio of BPC to prostate volume, and disease progression after robot-assisted radical prostatectomy (RARP). <b>Materials and Methods:</b> We retrospectively analyzed 1047 consecutive PCa patients treated with RARP between January 2013 and December 2021. Inclusion criteria were: ≥12 systematic biopsy cores, available PV measurement, and follow-up data. Patients with prior therapies were excluded. Disease progression (biochemical recurrence/persistence and/or loco-regional or distant recurrence) was analyzed using Cox proportional hazards models. <b>Results:</b> Disease progression occurred in 237 patients (22.6%) after a mean follow-up of 82.5 months. Id-BPC was significantly associated with disease progression and showed larger effect size estimates than BPC when evaluated in separate models (HR = 1.47; 95% CI: 1.29–1.67; <i>p</i> &lt; 0.001). Higher Id-BPC values were also associated with unfavorable pathology (HR = 1.37; 95% CI: 1.21–1.56; <i>p</i> &lt; 0.001). <b>Conclusions:</b> Id-BPC is independently associated with PCa progression after RARP and may provide additional prognostic information beyond BPC. It may represent a clinically useful marker of tumor aggressiveness.
KW  - prostate cancer; robot assisted radical prostatectomy; tumor index density; prostate cancer progression; prostate biopsy

DO  - 10.32604/cju.2026.081303