Quantification of tumor extension in prostate biopsies: importance in the identification of confined tumors

Abstract

Objective: To assess the importance of quantifying the adenocarcinoma in prostate biopsies when determining the tumor's final stage in patients who undergo radical prostatectomy. To identify the best methodology for obtaining such data.Patients and Methods: Prostate biopsies from 132 patients were examined, with determination of Gleason histological grade and tumor volume in number of involved fragments, tumor extent of the fragment mostly affected by the tumor and the total percentage of tumor in the specimen. Theses parameters were statistically correlated with the neoplasia's final stage following the evaluation of radical prostatectomy specimens.Results: An average of 12 and a median of 14 biopsy fragments were evaluated per patient. In the univariate analysis the Gleason histological grade, the largest tumor extent in one fragment and the total percentage of tumor in the specimen were correlated with tumor stage of the surgical specimen. In the multivariate analysis, the Gleason histological grade and the total percentage of tumor were strongly correlated with the neoplasia's final stage. The risk of the tumor not being confined was 3 for Gleason 7 tumors and 10.6 for Gleason 8 tumors or above. In cases where the tumor involved more than 60% of the specimen, the risk of non-confined disease was 4.4 times. Among 19 patients with unfavorable histological parameters, Gleason > 7 and extension greater than 60% the tumor final stage was pT3 in 95%.Conclusion: When associated to the Gleason histological grade, tumor quantification in prostate biopsies is an important factor for determining organ-confined disease, and among the methods, total percentage of tumor is the most informative one. Such data should be included in the pathological report and must be incorporated in future nomograms.

Thermal kinetics of color degradation of mulberry fruit extract

“…Therefore, the rates of brown pigment and degradation of color increased as the heating temperature became higher by pH increase. These values were slightly lower than the value given in nonenzymatic purple sweet potato anthocyanin pigment [14]. In the latter study, activation energy values of 69.57 kJ/mol for pH 2.0, 76.68 kJ/mol for pH 3.0, 81.07 kJ/mol for pH 4.0, and 92.98 kJ/mol for pH 5.0 were reported.…”

“…Color measurement was carried out according to the method of Lee and Rhim [14] using a spectrophotometer (Shimadzu 300 UV, Tokyo, Japan). Absorbance at 510 nm was measured for the anthocyanins of mulberry fruit extract anthocyanin and the increase of brown pigments was measured by the absorbance at 420 nm.…”

Probability of Extraprostatic Disease According to the Percentage of Positive Biopsy Cores in Clinically Localized Prostate Cancer

“…Leite et al in 2003 demonstrated the importance of determining the volume of the tumor when used in conjunction with the Gleason histological score, but the overall extent of tumor in the positive cores appeared to be the most informative of all parameters studied ( 18 ). In 2005, Antunes et al demonstrated the usefulness of the percentage of positive cores to determine the recurrence of prostate cancer ( 7 ).…”

“…The percentage of positive cores has been associated with tumor pathological features, biochemical recurrence, distant metastases, overall survival, capacity to determine extraprostatic extension of tumor and lymph node invasion, but most of these studies have some shortcomings such as small sample size and short term patients’ follow-up ( 11 – 18 ). Consequently, the use of serum PSA, clinical stage and Gleason score to predict the probability of the tumor extending outside the prostate still persist as useful prognostic tools up to the present days ( 4 ).…”

Prognostic value of the percentage of positive fragments in biopsies from patients with localized prostate cancer

“…However, despite all these results, the most accurate method for quantifying tumor volume in the prostate biopsy is still grounds for debate. Some studies have shown that more detailed analyses of prostate biopsies, such as the total percentage of cancerous tissue or a higher percentage of cancer in one affected fragment, are the most adequate methods for measuring tumor volume in prostate biopsies (18,19). In the series from Freedland et al (18), the percent-age of cancerous tissue at biopsy was a stronger predictive factor for post-operative biochemical recurrence than PSA and Gleason scores at biopsy.…”