Concordance between Gleason scores of needle biopsies and radical prostatectomy specimens: a population‐based study

Abstract

Gleason scores from biopsy and RP specimens. Concordance was evaluated using the κ coefficient, and predictors of concordance were assessed in univariate and multivariate logistic regression analyses. RESULTSThe Gleason scores were identical in biopsy and RP specimens in 591 of the 1116 (53%) patients. The biopsy-based Gleason score more often under-graded (38%) than overgraded (9%) the RP-based Gleason score. Pathology units that examined > 40 RP specimens annually had a higher concordance between the Gleason score in the biopsy and RP specimen than did lowervolume units. The rate of upgrading from a Gleason score of ≤ 6 in the biopsy to ≥ 7 in the RP specimen increased with increasing preoperative prostate-specific antigen serum levels, and with increasing intervals between biopsy and RP. CONCLUSIONSThe concordance in Gleason score between biopsy and RP was highest among the pathology departments that regularly evaluated RP specimens. Careful consideration of clinical factors and biopsy grading might improve the identification of patients considered as suitable for active surveillance.

Does diabetes mellitus increase the risk of high-grade prostate cancer in patients undergoing radical prostatectomy?

“…Unfortunately, high-grade PCa may be underestimated on biopsy in up to 38% of cases. [10][11][12][13] Consequently, the reported relationship between DM and tumor grade in the aforementioned studies might not be completely accurate. One recent report examined the relationship between DM and PCa grade in patients who underwent RP.…”

“…Prostate biopsy may misclassify Gleason score in up to 38% of cases. [10][11][12] To the best of our knowledge, this report represents the first European study to examine the relationship between DM and PCa grade in patients undergoing RP. In our study, the rate of DM was lower than that found in the North American reports (7.1 vs 10.2-19.0%).…”

Upgrading and upstaging in prostate cancer: From prostate biopsy to radical prostatectomy

“…The comparisons between the results of the histological biopsy compared to the surgical specimen exhibited a correlation equal to ~50% (14)(15)(16)(17). The results of the prostate biopsy and the surgical specimen may differ for several reasons, such as incorrect evaluation by the pathologist, sampling errors and the presence of borderline grading.…”

Predictors of overall survival in patients with metastatic castration-resistant prostate cancer

“…Нами использовались сведения о градации по Глисону преимущественно из гистоло-гических заключений, сделанных по биопсийному материалу, так как РПЭ была выполнена только у 19 (17,0 %) из 112 больных. По данным литературы, по-казатель Глисона при биопсии коррелирует с патомор-фологическим заключением после РПЭ только в 30-60 % случаев [18,19]. Возможно, при больших размерах выборки и большей прослеженности боль-ных можно было бы получить достоверные различия в зависимости от градации по Глисону.…”