Assessment of Gleason Score Concordance Between Prostate Biopsy and Radical Prostatectomy

İlker Akarken; Yelda Dere; Hüseyin Tarhan; Hayrettin Şahin

doi:10.36516/jocass.1122307

Clinical Research

Prostat biyopsi ve radikal prostatektomide Gleason skor konkordansının değerlendirilmesi

Year 2022, , 274 - 279, 31.08.2022

İlker Akarken , Yelda Dere , Hüseyin Tarhan , Hayrettin Şahin

https://doi.org/10.36516/jocass.1122307

Abstract

Introduction:
Prostate cancer is being diagnosed and graded by examining needle biopsies. As needle biopsies may represent the low percentage of general tumor histology, downgrading or upgrading can cause problems in radical prostatectomy (RP) specimens. Our aim in this study was to put forth the concordance between needle biopsy and RP Gleason scores.
Methods:
The biopsy pathology results, and post-RP pathology results of 112 patients diagnosed as prostate cancer and underwent RP were revised and the concordance of the biopsy and RP Gleason score was analyzed by kappa statistics in addition to percentages of downgrading or upgrading rates.
Results:
The mean age, and PSA values of the patients were 64,4 (±6,2) years, and 11,7 (±9,2) ng/mL, respectively. There was a moderate agreement between biopsy and prostatectomy gleason scores(κ=0,452) and between Gleason groups
Conclusion:
It is important for the urologists to be aware of the variety of Gleason score between biopsy results and prostatectomy specimens as needle biopsies represent small areas of tumors

Keywords

Downgrading, upgrading, Gleason score, prostate cancer

References

1. Greenlee RT, Hill-Harmon MB, Murray T, Thun M: Cancer statistics, 2001. CA Cancer J Clin 2001, 51(1):15-36.
2. Cooperberg MR, Pasta DJ, Elkin EP, Litwin MS, Latini DM, Du Chane J, Carroll PR. The University of California, San Francisco Cancer of the prostate risk assessment score: a straightforward and reliable preoperative indicator of disease recurrence after radical prostatectomy. J Urol 2005; 173 (6):1938-1942.
3. PA, Egevad L, Netto G, Amin MB, Epstein JI, Rubin MA. Acinar adenocarcinoma, Chapter 3: Tumors of the prostate in WHO Classification of Tumours of the Urinary System and Male Genital Organs. 4th edition, 2016; pp:152-154
4. Epstein JI, EgevadL,Amin MB, Delahunt B, Srigley JR, Humprey PA, the grading commitee. The 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma Definition of Grading Patterns and Proposal for a New Grading System. Am J of Surg Pathol 2016; 40(2):244-252
5. Cohen MS, Hanley RS, Kurteva T, et al. Comparing the Gleason prostate biopsy and Gleason prostatectomy grading system: the Lahey Clinic Medical Center experience and an international metaanalysis. Eur Urol2008;54:371-381.
6. Kuroiwa K, Shiraishi T, Naito S. Gleason score correlation between biopsy and prostatectomy specimens and prediction of high-grade Gleason patterns: significance of central pathologic review. Urology 2011;77:407-411.
7. Reis LO, Zani EL, Freitas LL, et al. Higher prostate weight is inversely associated with Gleason score upgrading in radical prostatectomy specimens. Adv Urol2013;2013:710421.
8. Van Praet C, Libbrecht L, D’Hondt F, et al. Agreement of Gleason score on prostate biopsy and radical prostatectomy specimen: is there improvement with increased number of biopsy cylinders and the 2005 revised Gleason scoring? Clin Genitourin Cancer 2014;12:160-166
9. Garnett JE, Oyasu R, Grayhack JT. The accuracy of diagnostic biopsy specimens in predicting tumor grades by Gleason’s classification of radical prostatectomy specimens. J Urol. 1984;131:690-693.
10. Bostwick DG. Gleason grading of prostatic needle biopsies. Correlation with grade in 316 matched prostatectomies. Am J Surg Pathol. 1994;18:796-803.
11. San Francisco IF, DeWolf WC, Rosen S, et al. Extended prostate needle biopsy improves concordance of Gleason grading between prostate needle biopsy and radical prostatectomy. J Urol2003;169:136-140.
12. Cookson MS, Fleshner NE, Soloway SM, et al. Correlation between Gleason score of needle biopsy and radical prostatectomy specimen: accuracy and clinical implications. J Urol1997;157:559-562.
13. Tilki D, Schlenker B, John M, Buchner A, Stanislaus P, Gratzke C, et al. Clinical and pathologic predictors of Gleason sum upgrading in patients after radical prostatectomy: results from a single institution series. Urol Oncol. 2011;29:508-514.
14. Öztürk E, Yıkılmaz TN. Gleason Score Correlation Between Prostate Biopsy and Radical Prostatectomy Specimens. Bulletin of Urooncology2018;17:1-4
15. Stav K, Judith S, Merald H, et al. Does prostate biopsy Gleason score accurately express the biologic features of prostate cancer? Urol Oncol 2007;25:383-386.
16. D’elia C, Cerruto MA, Cioffi A, et al. Upgrading and upstaging in prostate cancer: From prostate biopsy to radical prostatectomy. Mol Clin Oncol 2014;86:284-287.
17. Sahin A, Urkmez A, Yuksel OH, Verit A. Influence of Obesity on Gleason Score Inconsistencies between Biopsy and Radical Prostatectomy Specimens.J Coll Physicians Surg Pak. 2018;28(7):541-545.
18. Xu H, Bai PD, Hu MB, Mao SH, Zhu WH, Hu JM, et al. Infragradación de la biopsia de próstatarespecto a la pieza de prostatectomía la población China: nomogramasactualizados. ActasUrol Esp. 2017;41:162-171.
19. Payton S. Prostate cancer: new nomogram predicts risk of Gleason upgrading. Nature Rev Urol. 2013;10:553.
20. Pierorazio PM, Walsh PC, Partin AW, Epstein JI. Prognostic Gleason grade grouping: data based on the modified Gleason scoring system. BJU Int.2013;111:753–760.