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Localized prostate cancer gleason score 9,

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.

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In this context, localized prostate cancer gleason score 9 study aimed at analyzing the diagnostic concordance between localized prostate cancer gleason score 9 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.

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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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Author Biographies A. Lyon: International Agency for Research on Cancer, A contemporary prostate cancer grading system: A vali-dated alternative to the Gleason score. Eur Urol ; 69 3 : Gleason DF. Classification of prostatic carcinomas.

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Cancer Chemother Rep ; 50 3 Prediction of prognosis for prostatic adenocarcinoma by combined histo-logical grading and clinical staging.

J Urol ; 1 : Histological grading and staging of prostatic carcinoma. Philadephia: Lea and Feibiger, Histologic grading of prostate cancer: a perspective.

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Hum Pathol ; 23 3 : Am J Surg Pathol ; 29 9 : J Clin Oncol ; 27 21 : J Urol ; 6 : — Epstein JI. An update of the Gleason grading system.

Helpap B, Egevad L. Modified Gleason grading. An updated review.

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Histol Histopathol ; 24 5 : Eur Urol ; 58 3 : Arch Infectie urinara simptome Lab Med ; 4 : The impact of the Interna-tional Society of Urological Pathology Gleason grading consensus on active surveillance for prostate cancer. Cent European J Urol ; 70 4 : Upgrading and upstaging in prostate cancer: From prostate biopsy to radical prostatectomy.

Mol Clin Oncol ; 2 6 : J Clin Oncol ; 34 18 : Front Med Lausanne ; 4: Prostate cancer grading: a decade after the modified system.

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Mod Pathol ; 31 S1 : SS Grignon DJ. Prostate cancer reporting and staging: needle biopsy and radical prostatectomy specimens.

Preoperative prediction of Gleason grade in radical prostatectomy specimens: the influence of different Gleason grades from multiple positive biopsy sites.

Source: Romanian Journal of Urology. Author s : Rusu, A. Abstract: Prostate cancer is the most common malignancy in men. The incidence of prostate cancer has been rising since the early s. Not all men with prostate cancer will develop clinical disease, therefore sorting these cases is a great clinical challenge.

Mod Pathol localized prostate cancer gleason score 9 18 2 : Evaluation of concordance of Gleason score between prostatectomy and biopsies that show more than two different Gleason scores in positive cores. 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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Hum Pathol ; 40 4 : Should intervening benign tissue be included in the meas-urement of discontinuous foci of cancer on prostate needle biopsy? Correlation with radical prostatec-tomy findings. Am J Surg Pathol ; 35 9 : Continuous versus discontinuous tumor involvement: A di-lemma in prostate biopsy quantitation.

Prostate ; 78 15 : Prognostic value of percent Gleason grade 4 at prostate biopsy in predicting prostatectomy pathology and recurrence. J Urol ; 2 : A critical evaluation of visual proportion of Gleason 4 and maximum cancer core length quantified by histopathologists.

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Inter-observer variability of cribriform archi-tecture and percent Gleason pattern 4 in prostate cancer: relation to clinical outcome. Virchows Arch ; 2 : Gleason pattern 4 with cribriform morphology on biopsy is associated with adverse clinicopathological findings in a prospective radical prostatectomy cohort.

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Hum Pathol ; 98 4 : Hum Pathol ; 99 5 : King CR. Patterns of prostate cancer biopsy grading: trends and clinical implications. Int J Cancer ; 90 6 : Diagnostic accuracy of prostate biopsy for detecting cribriform Gleason pattern 4 carcinoma and intraductal carcinoma in paired radical prostatectomy specimens: implications for active surveillance.

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Humphrey PA. Prostate Pathology.