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A Contemporary Study Correlating Prostate Needle Biopsy and Radical Prostatectomy Gleason Score

2008; Lippincott Williams & Wilkins; Volume: 179; Issue: 4 Linguagem: Inglês

10.1016/j.juro.2007.11.057

1527-3792

Samson W. Fine, Jonathan I. Epstein,

Prostate Cancer Treatment and Research

No AccessJournal of UrologyAdult Urology1 Apr 2008A Contemporary Study Correlating Prostate Needle Biopsy and Radical Prostatectomy Gleason Scoreis accompanied byElectrical Impedance Spectroscopy of Benign and Malignant Prostatic TissuesPCA3: A Molecular Urine Assay for Predicting Prostate Biopsy Outcome Samson W. Fine and Jonathan I. Epstein Samson W. FineSamson W. Fine Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York and Jonathan I. EpsteinJonathan I. Epstein Departments of Pathology, Urology and Oncology, Johns Hopkins Hospital, Baltimore, Maryland View All Author Informationhttps://doi.org/10.1016/j.juro.2007.11.057AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined whether contemporary practice patterns of Gleason grading for prostate needle biopsy and radical prostatectomy have evolved. Materials and Methods: We correlated needle biopsy (assigned at Johns Hopkins Hospital and other institutions) and radical prostatectomy Gleason score for 1,455 men who underwent radical prostatectomy at Johns Hopkins Hospital from 2002 to 2003, and compared the results with those of a 1994 study of similar design. Results: Outside institutions diagnosed Gleason score 2–4 in 1.6% (23 of 1,455) of needle biopsies vs 22.3% (87 of 390) in 1994. Of needle biopsies labeled Gleason score 2–4, 30.4% revealed radical prostatectomy Gleason score 7–10. In 2002 to 2003 no Johns Hopkins Hospital needle biopsy was assigned Gleason score 2–4. Needle biopsies designated Gleason score 6 or less had 80.0% accuracy with regard to radical prostatectomy Gleason score vs 63% accuracy in older data. For needle biopsy Gleason score 7 or greater, 35.5% (outside institution) and 24.8% (Johns Hopkins Hospital) of radical prostatectomies displayed Gleason score less than 7. Overall, outside and Johns Hopkins Hospital needle biopsy diagnoses showed 69.7% and 75.9% agreement with radical prostatectomy Gleason score, respectively. Direct comparison of Johns Hopkins Hospital and needle biopsy Gleason scores elsewhere revealed 81.8% agreement, with 87.1% for Gleason score 5–6, 68.1% for Gleason score 7 and 35.1% for Gleason score 8–10. For 59.4% of outside needle biopsies with Gleason score 8–10, Johns Hopkins Hospital Gleason score was 7 or less. Conversely, for 64.9% of Johns Hopkins Hospital needle biopsies with Gleason score 8–10, outside Gleason score was 7 or less. For needle biopsies with Gleason score 5–6, 7 and 8–10, the incidence of nonorgan confined disease at radical prostatectomy was 17.7%, 47.8% and 50.0%, respectively, for Johns Hopkins Hospital vs 18.2%, 44.6% and 37.5% for outside institutions. Conclusions: The last decade has seen the near elimination of once prevalent under grading of needle biopsy. All cases still assigned Gleason score 2–4 show Gleason score 5 or greater at radical prostatectomy and nearly a third reveal Gleason score 7–10, reaffirming that Gleason score 2–4 is a needle biopsy diagnosis that should not be made. As evidenced by variable over grading and under grading, as well as poor correlation with pathological stage, difficulties in the assignment of Gleason pattern 4 and overall Gleason score of 8–10 on needle biopsy remain an important issue. References 1 : Reliability of Gleason grading system in comparing prostate biopsies with total prostatectomy specimens. Urology1985; 25: 564. Google Scholar 2 : Gleason grading of prostatic needle biopsies: correlation with grade in 316 matched prostatectomies. Am J Surg Pathol1994; 18: 796. Google Scholar 3 : The accuracy of diagnostic biopsy specimens in predicting tumor grades by Gleason's classification of radical prostatectomy specimens. J Urol1984; 131: 690. 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Google Scholar © 2008 by American Urological AssociationFiguresReferencesRelatedDetailsCited byDinh K, Mahal B, Ziehr D, Muralidhar V, Chen Y, Viswanathan V, Nezolosky M, Beard C, Choueiri T, Martin N, Orio P, Sweeney C, Trinh Q and Nguyen P (2018) Incidence and Predictors of Upgrading and Up Staging among 10,000 Contemporary Patients with Low Risk Prostate CancerJournal of Urology, VOL. 194, NO. 2, (343-349), Online publication date: 1-Aug-2015.Arvold N, Chen M, Moul J, Moran B, Dosoretz D, Bañez L, Katin M, Braccioforte M and D'Amico A (2018) Risk of Death From Prostate Cancer After Radical Prostatectomy or Brachytherapy in Men With Low or Intermediate Risk DiseaseJournal of Urology, VOL. 186, NO. 1, (91-96), Online publication date: 1-Jul-2011.McKenney J, Simko J, Bonham M, True L, Troyer D, Hawley S, Newcomb L, Fazli L, Kunju L, Nicolas M, Vakar-Lopez F, Zhang X, Carroll P and Brooks J (2018) The Potential Impact of Reproducibility of Gleason Grading in Men With Early Stage Prostate Cancer Managed by Active Surveillance: A Multi-Institutional StudyJournal of Urology, VOL. 186, NO. 2, (465-469), Online publication date: 1-Aug-2011.Kuroiwa K, Shiraishi T, Ogawa O, Usami M, Hirao Y and Naito S (2018) Discrepancy Between Local and Central Pathological Review of Radical Prostatectomy SpecimensJournal of Urology, VOL. 183, NO. 3, (952-957), Online publication date: 1-Mar-2010.Venkataraman G, Rycyna K, Rabanser A, Heinze G, Baesens B, Ananthanarayanan V, Paner G, Barkan G, Flanigan R and Wojcik E (2018) Morphometric Signature Differences in Nuclei of Gleason Pattern 4 Areas in Gleason 7 Prostate Cancer With Differing Primary Grades on Needle BiopsyJournal of Urology, VOL. 181, NO. 1, (88-94), Online publication date: 1-Jan-2009.Boorjian S, Karnes R, Crispen P, Rangel L, Bergstralh E, Sebo T and Blute M (2018) The Impact of Discordance Between Biopsy and Pathological Gleason Scores on Survival After Radical ProstatectomyJournal of Urology, VOL. 181, NO. 1, (95-104), Online publication date: 1-Jan-2009.Rice K, Furusato B, Chen Y, McLeod D, Sesterhenn I and Brassell S (2018) Clinicopathological Behavior of Single Focus Prostate AdenocarcinomaJournal of Urology, VOL. 182, NO. 6, (2689-2694), Online publication date: 1-Dec-2009.Related articlesJournal of Urology22 Feb 2008Electrical Impedance Spectroscopy of Benign and Malignant Prostatic TissuesJournal of Urology22 Feb 2008PCA3: A Molecular Urine Assay for Predicting Prostate Biopsy Outcome Volume 179Issue 4April 2008Page: 1335-1339 Advertisement Copyright & Permissions© 2008 by American Urological AssociationKeywordsneedleprostatectomybiopsyneoplasm stagingMetricsAuthor Information Samson W. Fine Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author Jonathan I. Epstein Departments of Pathology, Urology and Oncology, Johns Hopkins Hospital, Baltimore, Maryland More articles by this author Expand All Advertisement PDF downloadLoading ...