Gleason score correlation between prostate needle biopsy and radical prostatectomy materials

Abstract

Objective: Prostate cancer is the second most common cancer in men. Digital rectal examination, transrectal ultrasonography and serum prostate specific antigen represents a diagnostic triad for the detection of prostatic carcinoma. About 50 years ago, Dr. Donald Gleason created a grading system for prostate cancer based on its histologic patterns. Currently, this system maintains its validity with various changes. New updates were made in 2005 and 2014 by the International Society of Urological Pathology. The goal of biopsies is to determine the Gleason score and prognosis in prostatectomy material. The aim of this study was to determine the concordance of the Gleason score, tumor volume and tumor laterality between prostate needle biopsy and prostatectomy materials. Material and Method:The study was performed with 112 patients who had biopsy and prostatectomy materials. The Gleason grades of the tumors have been evaluated with the new grading system. Tumor volumes were calculated by the number of positive blocks while tumor laterality was evaluated as unilateral or bilateral. Statistical analysis was performed on the obtained data.Results: Gleason score, tumor volume and tumor laterality discordance between needle biopsy and prostatectomy materials was found to be statistically significant. However, the concordance increased as the Gleason score and tumor volume increased. Conclusion:Digital examination, serum prostate specific antigen value and needle biopsy together are very sensitive for a prostate adenocarcinoma diagnosis. The Gleason score, localization and volume of the tumors are important for patient follow-up, treatment and prognosis.

The Impact of Gleason Score From the Biopsy and From the Radical Prostatectomy on the Biochemical Progression-Free Survival

“…But the problem is that the survival probability after RP is related to the GS from the operation and the survival probability after radiotherapy -to the GS from the biopsy. Both GSs often do not coincide [11,12,14,15]. The results of our study show that both GSs have a similar implication on the BPFS, with prostatectomy-GS giving slightly better results.…”

“…A difference was found only for the prostatectomy-GS but not for the one from the biopsy. Probably it is connected with the fact that the biopsy-GS is not so accurate, which is well-proven in the literature [8,9,10,11,12]. Next, we made a more sophisticated…”

18F‐DCFPyL positron emission tomography/magnetic resonance imaging‐guided ultrasound fusion biopsy is an identical pathway in prostate cancer diagnosis

“…Following the categorization of 18 F-DCFPyL PET/MR results mentioned above, 32% (30 of 94) of the patients received a score of 4, 33% (31 of 94) a score of 3; 24.5% (23 of 94) a score of 2, while 10.6% (10 of 94) a score of 1.…”

Understanding the gleason grading system and its changes

“…The new grading system and the terminology "Grade Groups 1-5" has also been accepted by the World Health Organization for the 2016 edition of Pathology and Genetics: Tumours of the Urinary System and Male Genital Organs. 21,28 In needle biopsies, the risk of under grading biopsy Gleason scores 6 must be considered to choose the treatment modality as preoperative Gleason score is often upgraded after an RP. By increasing the amount of tissue in prostate biopsy is one way to avoid the undergrading.…”