Single-Focus Prostate Caner: A Comparison of Biopsy and Radical Prostatectomy Specimen Features
Went Erol, Faruk Ozcan, Tank Esen, Murat Tunc, Iin Kilicaslan
article (Uluslararası, Hakemli) | Yazar(lar): Went Erol, Faruk Ozcan, Tank Esen, Murat Tunc, Iin Kilicaslan | Yıl: 2008 — Özet: The purpose of this study was to determine whether a single focus of prostate cancer in a needle biopsy specimen correlates with predicitive tumor volume and Gleason score in prostatectomy spe
The purpose of this study was to determine whether a single focus of prostate cancer in a needle biopsy specimen correlates with predicitive tumor volume and Gleason score in prostatectomy specimen. We reviewed pathology reports in from all transrectal needle biopsies of the prostate (680) performed from January 1996 through February 2002 litanbul Medical faculty. We identified 38 prostate biopsies that purported to show a single focus of carcinoma, defined either as tumor with only one identifiable Gleason grade or as tumor confined to only one core of the needle biopsy specimen. Twenty one of these 38 specimens met our definition of microscopic focus of adenocarcinoma; tumor occupying less than 2 nm in length of the entire biopsy specimen. TRUS prostate biopsies were compared regarding the Gleason grade/score, tumor volume, as well as extraprostatic extension. A total of 38 patients had a diagnosis of single-focus prostate cancer who were 43 to 78 years old (mean 62.9). Mean Gleason scores was 5.1 +/- 1.5 (range 2 to 7) in biopsy specimen, while it was 5.7 +/- 0.9 (range 4 to 7) in prostatectomy specimens (p>0.05). For Gleason score, there was an exact agreement in 57.8% (n=22) of cases and a difference of +/- 1 in 23.6% (n=9) and +/- 2 in 21% (n=8) of cases. Four cases were downgraded by one unit and 4 cases were upgraded by two unit (p>0.05). There was a mena of 3.9 +/- 1.1% and 19 +/- 9.1% cancer positive cores in biopsy and prostatectomy specimens, respectively. Fifteen of 21 (tumor volume less than 2 min) patients (71.4%) cancer was confined to prostate gland at prostatectomy (stage T2 or less). Single focus prostate cancer is not predictive for tumor volume and Gleason grade and/or score in prostatectomy specimen. However, the patients undergoing radical prostatectomy who have microfoci of tumor in the needle biopsy specimen a very high chance of having organ-confined disease.