Correlation between Gleason score of needle biopsy and radical prostatectomy tissue

Cecchi, M; Minervini, R.; Sepich, C.A.; Ippolito, Carmelo; Pagni, G; Summonti, D; Benedetto, Adriana Di; Fiorentini, L

doi:10.1007/bf02550548

Cited by 11 publications

(9 citation statements)

References 10 publications

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“…The most frequently reported error when evaluating Gleason scores at biopsy is undergrading, which is up to 57% in some studies [4–11]; the present results show a similar tendency. Although grouping Gleason scores markedly improved the accuracy (48.5% vs 29%), undergrading remained the most prevalent error.…”

Section: Discussionsupporting

confidence: 84%

“…The rate of identical grading in the present study was compared with those in previous studies in Table 4[4,5,7–17]; the rates were similar to studies in similar community settings with several pathologists, e.g. [4].…”

Section: Discussionsupporting

confidence: 79%

“…This is even more important in patients receiving radiotherapy or watchful waiting, as it is the only information available to establish a prognosis and a treatment plan. The accuracy of such an estimate is reported to be poor by some authors [4,5] and as acceptable by others [6].…”

Section: Introductionmentioning

confidence: 99%

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Gleason score on biopsy: is it reliable for predicting the final grade on pathology?

Lattouf

Saad

2002

BJU International

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Objective To assess the correlation of the Gleason score on biopsy and the final pathology after radical prostatectomy (RP) for prostate adenocarcinoma. Patients and methods In a retrospective analysis within a tertiary-care centre, the charts of 537 patients who had undergone radical prostatectomy from April 1989 to November 2000 were reviewed. The RPs were undertaken in one institution; 167 biopsies were taken and interpreted in the referring centres, and 355 were taken and interpreted in the authors' institution by up to 15 pathologists. All the final pathology specimens were interpreted by the same group of pathologists. The main outcome measures were: the pathological report of the biopsy including the primary and secondary Gleason grade; the final pathological grade (primary and secondary); the margin status; and the identification of the pathologist for the biopsy and final pathology. Results In all, 390 patients had inclusion criteria (the Gleason grade before and after RP) available. For the individual scores 38.2% of tumours were undergraded, 32.6% overgraded and only 29.2% had identical grading in preoperative biopsies and final specimens. When grouped into more meaningful categories (Gleason 2-4, 5-6, 7 and 8-10) the correlation improved, with 48.5% of patients remaining in the same group after RP. For 39 patients the same pathologist assessed the biopsy and final specimen; in these cases individual scores were identical in 49% and group scores were identical in 64%. Conclusion Gleason grading of the prostate biopsy remains a poor predictor of pathological outcome. Assessment by the same pathologist reduces the discrepancy but over half the patients are under-or overgraded on final pathology. Clinicians should be aware of these limitations when using the biopsy Gleason grade in decision making.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 79%

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Gleason score on biopsy: is it reliable for predicting the final grade on pathology?

Lattouf

Saad

2002

BJU International

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“…reported that only 47% of Gleason scores were identical in the biopsy and prostatectomy specimens, while Carlson et al . showed that 68% of biopsy and prostatectomy specimens were the same 13,14 . Cookson et al .…”

Section: Discussionmentioning

confidence: 99%

Accuracy of transrectal ultrasound guided prostate biopsy: Histopathological correlation to matched prostatectomy specimens

et al. 2002

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Background : The Gleason grading system is currently the world's most commonly used histological system for prostate cancer. It provides significant information about the prognosis. Therefore, Gleason score is accepted as an important factor in therapeutic decision-making for prostate cancer. This retrospective study assessed the correlation of transrectal ultrasound (TRUS) guided biopsy and radical prostatectomy specimens in terms of Gleason scores. Methods : We reviewed the records of 103 patients who underwent radical prostatectomy due to clinically localized prostate cancer. The Gleason scores of the TRUS biopsies were compared with the respective Gleason scores of surgical specimen.Results : In 28.7% of cases, the TRUS biopsy score was the same as that of the radical prostatectomy specimen. The most significant discordance was the upgrading of well-differentiated tumors after surgery in 71.7% of cases. However, in 81.8% of cases with high Gleason score on TRUS, biopsy was correlated with poorly differentiated tumor after surgery. Conclusions : Well-differentiated tumors on TRUS biopsy did not correlate with the grades of final pathology in the majority of cases; however, a high Gleason score on TRUS biopsy usually indicated a poorly differentiated tumor on prostatectomy specimen. Therefore, the treatment algorithms for particularly well-differentiated tumors should not be deduced from biopsy histology alone.

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“…As the number of positive cores and the amount of tumor per core increase, the larger the tumor volume is likely to be. It is easy to understand why EPBx and SPBx might be necessary in the different settings to provide a correct diagnosis and evaluation of the prostate cancer that has been detected 125–133 (Table 7).…”

Section: Pathological Issuesmentioning

confidence: 99%

Is extended and saturation biopsy necessary?

Scattoni¹,

Maccagnano²,

Zanni³

et al. 2010

Int J of Urology

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Prostate biopsy (PBx) techniques have significantly changed since the original Hodge's 'sextant scheme', which should now be considered obsolete. The feasibility of carrying out a biopsy scheme with a high number of cores in an outpatient setting is a result of the great improvement and efficacy of local anesthesia. Peri-prostatic nerve block with lidocaine injection should be considered the 'gold standard' because it provides the best pain relief to patients undergoing PBx. The optimal extended protocol should now include the sextant template with an additional 4-6 cores directed laterally (anterior horn) to the base and medially to the apex. Saturation biopsies (i.e. template with > or = 20 cores, including transition zone) should be carried out only when biopsies are repeated in patients where there is a high suspicion of prostate cancer. Complementary imaging methods (such as color- and power-Doppler imaging, with or without contrast enhancement, and elastography) could be used in order to increase the accuracy of biopsy and reduce the number of unnecessary procedures. Nevertheless, the routine use of these methods is still under evaluation.

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Correlation between Gleason score of needle biopsy and radical prostatectomy tissue

Cited by 11 publications

References 10 publications

Gleason score on biopsy: is it reliable for predicting the final grade on pathology?

Gleason score on biopsy: is it reliable for predicting the final grade on pathology?

Accuracy of transrectal ultrasound guided prostate biopsy: Histopathological correlation to matched prostatectomy specimens

Is extended and saturation biopsy necessary?

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