Comparison of prostate biopsy pathology and radical prostatectomy pathologies

Abstract

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.