There is a discrepancy in the Gleason score given on the initial biopsy and prostatectomy specimen, respectively, that affects both patients who can benefit from active surveillance and those who cannot benefit from curative surgical treatment, and for whom therapeutic alternatives must be established.
In this context, our study aimed at analyzing the diagnostic concordance between biopsies and subsequent prostatectomies, in order to establish the accuracy of prostate biopsy in predicting final Gleason score of the prostatectomy specimens. Material and methods: We analyzed 79 cases of PADK, initially diagnosed by prostate biopsy and subsequently treated by radical prostatectomy.
The accuracy degree of the tumoral grading system assigned to the prostate biopsy, compared with the radical prostatectomy, was assessed by calculation of the Cohen's kappa concordance coefficient and calculation of sensitivity, specificity, positive prognostic value and negative prognostic value. Results: 37 cases In prostate biopsies, 32 cases The lowest agreement rate was observed for Gleason score 5, where no case showed a similar score for biopsy and prostatectomy.
Statistical analysis indicated a kappa coefficient of 0.
The agreement on ISUP prognostic grade groups between prostate biopsy and radical prostatectomy indicated a slight increase in kappa coefficient Conclusions: Our results demonstrate an increase in the predictive accuracy of prostate biopsy, as a result of the application of prognostic grade group system, which ensure the decrease of overestimating tendency of the old scoring system, ultimately leading to a preliminary characterization of potential lesions in prostatectomy specimens and a more effective treatment stratification of patients.
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Multiparametric Magnetic Resonance Imaging in prostate cancer diagnosis: a must
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PROSTATE CANCER: What's my prognosis? - Grade, Stage, PSA, Gleason score and novel genomic assays
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Preoperative prediction of Gleason grade in radical prostatectomy specimens: the influence of different Gleason grades from multiple prostate cancer survival rate gleason score 8 biopsy sites.
Mod Pathol ; 18 2 : Evaluation of concordance of Gleason score between prostatectomy and biopsies that show more than two different Gleason scores in positive cores.
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- Source: Acta Medica Transilvanica.
- Magnetic Resonance Imaging MRI is the best imaging modality for evaluating the prostate and accurately diagnose the prostatic carcinoma, especially in cases with aggressive and larger volume tumors.
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Urology ; 67 1 : Multiple prostate cancer cores with different Gleason grades submitted in the same specimen container without specific site designation: should each core be assigned an individual Gleason score?
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