International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 2: T2 substaging and prostate cancer volume

Abstract

The 2009 International Society of Urological Pathology consensus conference in Boston made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to the substaging of pT2 prostate cancers according to the TNM 2002/2010 system, reporting of tumor size/ volume and zonal location of prostate cancers were coordinated by working group 2. A survey circulated before the consensus conference demonstrated that 74% of the 157 participants considered pT2 substaging of prostate cancer to be of clinical and/or academic relevance. The survey also revealed a considerable variation in the frequency of reporting of pT2b substage prostate cancer, which was likely a consequence of the variable methodologies used to distinguish pT2a from pT2b tumors. Overview of the literature indicates that current pT2 substaging criteria lack clinical relevance and the majority (65.5%) of conference attendees wished to discontinue pT2 substaging. Therefore, the consensus was that reporting of pT2 substages should, at present, be optional. Several studies have shown that prostate cancer volume is significantly correlated with other clinicopathological features, including Gleason score and extraprostatic extension of tumor; however, most studies fail to demonstrate this to have prognostic significance on multivariate analysis. Consensus was reached with regard to the reporting of some quantitative measure of the volume of tumor in a prostatectomy specimen, without prescribing a specific methodology. Incorporation of the zonal and/or anterior location of the

International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 1: specimen handling

“…The results of the individual working group reports related to T2 substaging, extraprostatic extension, seminal vesicle and lymph node involvement and margin status are reported separately. [13][14][15][16] Many recommendations of this consensus conference have already been incorporated into international guidelines, including the recent College of American Pathologists protocol and checklist for reporting adenocarcinoma of the prostate and the structured reporting protocol for prostatic carcinoma from the Royal College of Pathologists of Australasia. 17,18 Specimen transportation Typically, radical prostatectomy specimens are transported in 10% buffered formal saline.…”

International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 5: surgical margins

“…The results of the individual working group reports related to specimen handling, T2 substaging, extraprostatic extension and seminal vesicle and lymph node involvement are reported separately. [13][14][15][16] Many recommendations of this consensus conference have already been incorporated into international guidelines, including the recent College of American Pathologists protocol and checklist for reporting adenocarcinoma of the prostate, and the structured reporting protocol for prostatic carcinoma from the Royal College of Pathologists of Australasia. 17,18 Definition and criteria for positive surgical margins A positive surgical margin can be defined as tumor that extends to the surface of the prostate wherein the surgeon has cut across the tissue plane.…”

Relationship Between Tumor Density in Radical Prostatectomy Material, Preoperative Predictive Factors and Biochemical Recurrence

“…Buna neden olan en önemli etkenlerden birinin çalışmalar arası tümör hacim ölçümündeki yöntem farklılıkları, diğeri ise tümör hacmi eşit olan hastalardaki prostat volüm farklılıklarıdır (11). Tümör hacim ölçümüne baktığımızda, en doğru ölçüm yönteminin bilgisayar ile yapılan görüntü analizi olduğu bilinmektedir (24,25). Ancak, bu yöntem hem zaman alıcı hem de yazılımı her patoloji laboratuvarında bulunmamaktadır.…”