Comparison of prostate biopsy pathology and radical prostatectomy pathologies
Öz
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.
Anahtar Kelimeler
Kaynakça
- 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.
Ayrıntılar
Birincil Dil
İngilizce
Konular
Sağlık Kurumları Yönetimi
Bölüm
Araştırma Makalesi
Yazarlar
Ahmet Camtosun
*
Bu kişi benim
0000-0002-5390-9088
Hasan Gökçe
Bu kişi benim
0000-0002-4658-9987
Yayımlanma Tarihi
3 Mart 2019
Gönderilme Tarihi
23 Kasım 2018
Kabul Tarihi
4 Aralık 2018
Yayımlandığı Sayı
Yıl 2019 Cilt: 46 Sayı: 1