Comparison of prostate biopsy pathology and radical prostatectomy pathologies

Year 2019, Volume: 46 Issue: 1, 133 - 139, 03.03.2019

Ahmet Camtosun Hasan Gökçe

https://doi.org/10.5798/dicletip.534851

Cited By: 2

Abstract

Objectives:
The rate of prostate cancer has increased with the identification of the
prostate-specific antigen; however, data on biopsy pathologies determined by
transrectal ultrasonography may be incompatible with the pathology indicated in
radical prostatectomy specimens. This situation puts patients in need of
curative treatment at risk while in some patients they are overtreatment. The
aim of this study was to compare Gleason scores in radical prostatectomy
specimens with the Gleason scores determined by transrectal ultrasound-guided
biopsy pathologies.

Methods:
The data of patients who underwent radical prostatectomy in our clinic between
January 2007 and November 2018 were evaluated retrospectively. Data included
preoperative biopsy values, biopsy cores, biopsy percentage, Gleason scores
from transrectal ultrasound-guided pre-biopsy biopsy cores, Gleason scores
after radical prostatectomy, tissue cancer rates, surgical margins, and pathological
stage. The ISUP-WHO (Society of Urological Pathology: ISUP-World Health
Organization) 2014 classification was used for the pathological classification.

Results: A
total of 159 patients were evaluated. Transrectal ultrasonography-guided biopsy
pathology revealed that 82 (75.9%) patients with Gleason scores <7 had
radical prostate pathology with Gleason scores of <7. Transrectal
ultrasonography-guided biopsy pathology revealed a Gleason score of 7 in 10
(38.4%) patients. The Gleason score was > 7 in 24 (48.9%) of the patients
who had a Gleason score> 7 based on transrectal ultrasonography-guided
pathology. The radical pathology of 109 patients with biopsy pathology was ISUP
1 in 83 (76.1%) patients. The radical pathology was ISUP 3 in 5 of 16 patients
with biopsy pathology ISUP 3 (31.2%). Six patients with biopsy pathology ISUP 4
and 2 patients with ISUP 5 was reported at different stages.

Conclusions:
Differences occur between the Gleason scores reported in transrectal
ultrasonography-guided biopsy and radical prostatectomy pathologies. These
differences become more evident as age increases, as PSA level increases and as
prostate volume decreases.

Keywords

Prostate cancer, biopsy

References

• 1. Seaman E, Whang M, Olsson CA, et all. PSA density (PSAD). Role in patient evaluation and management. The Urologic Clinics of North America 1993; 20: 653-63.
• 2. Bazinet M, Meshref AW, Trudel C, et all. Prospective evaluation of prostate-specific antigen density and systematic biopsies for early detection of prostatic carcinoma. Urology 1994; 43: 44-51.
• 3. Rommel FM, Agusta VE, Breslin JA, et all. The use of prostate specific antigen and prostate specific antigen density in the diagnosis of prostate cancer in a community based urology practice. The Journal of Urology 1994; 151: 88-93.
• 4. Andriole GL, Crawford ED, Grubb III RL, et all. Prostate cancer screening in the randomized Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial: mortality results after 13 years of follow-up. Journal of the National Cancer Institute 2012; 104: 125-32.
• 5. Fine SW, Epstein JI. A contemporary study correlating prostate needle biopsy and radical prostatectomy Gleason score. The Journal of Urology 2008; 179:1335-9.
• 6. Epstein JI, Feng Z, Trock BJ, Pierorazio PM. Upgrading and downgrading of prostate cancer from biopsy to radical prostatectomy: incidence and predictive factors using the modified Gleason grading system and factoring in tertiary grades. European Urology 2012; 61: 1019-24.
• 7. Tilki D, Schlenker B, John M, et all. Clinical and pathologic predictors of Gleason sum upgrading in patients after radical prostatectomy: results from a single institution series. Urol Oncol 2011; 29: 508-14.
• 8. Sarici H, Telli O, Yigitbasi O, et all. Predictors of Gleason score upgrading in patients with prostate biopsy Gleason score≤ 6. Can Urol Assoc J 2014; 8: 342-6.
• 9. Şahinkanat T, Küçükdurmaz F, Efe E, rt all. Prostat adenokarsinomlarında iğne biyopsileri ve radikal prostatektomi materyallerinin Gleason skoru açısından karşılaştırılması. Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi 2016; 12: 25-30.
• 10. Yazıcı CM, Türker P, Şahin MF, Özcan R. Prostat kanserinde aktif izlem kararı; biyopsi Gleason skoru ne kadar güvenli? Namık Kemal Tıp Dergisi 2017; 5: 58-62.
• 11. Turley RS, Hamilton RJ, Terris MK, et all. Small transrectal ultrasound volume predicts clinically significant Gleason score upgrading after radical prostatectomy: results from the SEARCH database. The Journal of Urology 2008; 179: 523-8.
• 12. Sebo TJ, Bock BJ, Cheville JC, et all. The percent of cores positive for cancer in prostate needle biopsy specimens is strongly predictive of tumor stage and volume at radical prostatectomy. The Journal of Urology 2000; 163: 174-8.
• 13. Kuroiwa K, Shiraishi T, Naito S. Clinicopathological Research Group for Localized Prostate Cancer Investigators. Gleason score correlation between biopsy and prostatectomy specimens and prediction of high-grade Gleason patterns: significance of central pathologic review. Urology 2011; 77: 407-11.
• 14. Poulos CK, Daggy JK, Cheng L. Prostate needle biopsies: multiple variables are predictive of final tumor volume in radical prostatectomy specimens. Cancer: Interdisciplinary International Journal of the American Cancer Society 2004; 101: 527-32.
• 15. Moon SJ, Park SY, Lee TY. Predictive factors of Gleason score upgrading in localized and locally advanced prostate cancer diagnosed by prostate biopsy. Korean Journal of Urology 2010; 51: 677-82.
• 16. Nayyar R, Singh P, Gupta NP, et all. Upgrading of Gleason score on radical prostatectomy specimen compared to the pre-operative needle core biopsy: An Indian experience. Indian J Urol 2010; 26: 56–9.
• 17. Corcoran NM, Hovens CM, Hong MK, et all. Underestimation of Gleason score at prostate biopsy reflects sampling error in lower volume tumours. BJU Int 2012; 109: 660-4.
• 18. King CR, McNeal JE, Gill H, Presti JC Jr. Extended prostate biopsy scheme improves reliability of Gleason grading: implications for radiotherapy patients. Int J Radiat Oncol Biol Phys 2004; 59: 386-91.
• 19. Divrik RT, Eroglu A, Şahin A, Zorlu F, Özen H. Increasing the number of biopsies increases the concordance of Gleason scores of needle biopsies and prostatectomy specimens. Urologic Oncology: Seminars and Original Investigations 2007; 25: 376 -82.
• 20. Moussa AS, Meshref A, Schoenfield L, et all. Importance of additional “extreme” anterior apical needle biopsies in the initial detection of prostate cancer. Urology 2010; 75: 1034-9.
• 21. Abdel-Khalek M, Sheir KZ, El-Baz M, Ibrahiem el-H. Is transition zone biopsy valuable in benign prostatic hyperplasia patients with serum prostate-specific antigen> 10 ng/ml and prior negative peripheral zone biopsy? Scand J Urol Nephrol 2005; 39: 49-55.
• 22. Van Nieuwenhove S, Saussez TP, Thiry S, et all. Prospective comparison of a fast 1.5 T biparametric to the 3.0 T multi‐parametric ESUR magnetic resonance imaging protocol as triage test for men at risk of prostate cancer. BJU Int 2018. doi:10.1111/bju.14538
• 23. Schatten H. Cell & Molecular Biology of Prostate Cancer. Springer 2018; 111-23.
• 24. Capitanio U, Karakiewicz PI, Valiquette L, et all. Biopsy core number represents one of foremost predictors of clinically significant Gleason sum upgrading in patients with low-risk prostate cancer. Urology 2009; 73: 1087-91.
• 25. Ayres BE, Montgomery BS, Barber NJ, et all. The role of transperineal template prostate biopsies in restaging men with prostate cancer managed by active surveillance. BJU Int 2012; 109:1170-6.
• 26. Takashima R, Egawa S, Kuwao S, Baba S. Anterior distribution of Stage T1c nonpalpable tumors in radical prostatectomy specimens. Urology 2002; 59: 692-7.
• 27. Pereira RA, Costa RS, Muglia VF, et all. Gleason score and tumor laterality in radical prostatectomy and transrectal ultrasound-guided biopsy of the prostate: a comparative study. Asian journal of Andrology 2015; 17: 815-20.
• 28. Crawford ED, Rove KO, Barqawi AB, et all. Clinical‐pathologic correlation between transperineal mapping biopsies of the prostate and three‐dimensional reconstruction of prostatectomy specimens. The Prostate 2013; 73: 778-87.
• 29. Krughoff K, Eid K, Phillips J, et all. The accuracy of prostate cancer localization diagnosed on transrectal ultrasound-guided biopsy compared to 3-dimensional transperineal approach. Advances in Urology 2013. Article ID 249080, 5 pages.
• 30. Kim JJ, Byun S-S, Lee SE, et all. A negative multiparametric magnetic resonance imaging finding does not guarantee the absence of significant cancer among biopsy-proven prostate cancer patients: a real-life clinical experience. International urology and nephrology 2018; 50: 1989-97.
• 31. Queiroz MRG FP, Mariotti GC, Lemos GC, et all. Comparison of complications rates between multiparametric magnetic resonance imaging-transrectal ultrasound (TRUS) fusion and systematic TRUS prostatic biopsies. Abdom Radiol 2018; Doi: 10.1007/s00261-018-1782-y
• 32. Schoots IG, Roobol MJ, Nieboer D, et all. Magnetic Resonance Imaging–targeted Biopsy May Enhance the Diagnostic Accuracy of Significant Prostate Cancer Detection Compared to Standard Transrectal Ultrasound-guided Biopsy: A Systematic Review and Meta-analysis. European Urology 2015; 68: 438-50.