The Comparison of ISUP Grades Between Prostate Biopsy and Radical Prostatectomy: The Incoherence and Related Factors

Objective: To assess the incoherence rates between prostate biopsies and radical prostatectomy specimens with the use of the International Society of Urological Pathology grading system and to identify the related factors. Materials and Methods: 89 radical prostatectomy patients were analyzed retrospectively. Patients with Gleason score≥6 were included to the study. Patients’ prostate spesific antigen levels, digital rectal examination, prostate biopsy parameters, prostate cancer risk groups and final prostatectomy pathologies were examined. Gleason scores and International Society of Urological Pathology grades of prostate biopsy and prostatectomy specimens were compared. The coherence, upgrading and downgrading rates of pathologies assessed and related factors were identified. Results: Patients’ mean age was 63.1±6.0 years. Prostate spesific antigen levels ranged from 2.8 to 114.0ng/mL(mean:14.8±16.7). The mean number of cores biopsied was 10.9±3.1. Number of patients in low, intermediate and high risk group were 27(30.3%), 34(38.2%) and 28(31.5%) respectively. The coherence, upgrading and downgrading rates according to International Society of Urological Pathology grading were 49.4%, 33.7% and 16.9% respectively. The low risk prostate cancer group showed the most coherent pathologies with the rate of 70.4%(p<0.05, both for International Society of Urological Pathology grading and Gleason scoring). There was no significant relation between prostate spesific antigen level, number of cores biopsied, percentage of cancer involvement, presence of perineural invasion coherence, upgrading and downgrading. Also no significant difference found between coherent, upgrading and downgrading pathologies with respect to the time to radical prostatectomy. Conclusion: The incoherence between prostate biopsy and radical prostatectomy is challenging. Risk of upgrading and downgrading should be considered in decision making. Low risk prostate cancer shows the most coherent pathology between prostate biopsy and radical prostatectomy.

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Comparison of pathological data between prostate biopsy and radical prostatectomy specimen in patients with low to very low risk prostate cancer

Actas Urológicas Españolas (English Edition) ◽

10.1016/j.acuroe.2015.07.004 ◽

2015 ◽

Vol 39 (8) ◽

pp. 482-487 ◽

Cited By ~ 4

Author(s):

G. Lendínez-Cano ◽

J. Alonso-Flores ◽

V. Beltrán-Aguilar ◽

A. Cayuela ◽

S. Salazar-Otero ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Prostate Biopsy ◽

Low Risk ◽

Radical Prostatectomy Specimen ◽

Risk Prostate Cancer ◽

Low Risk Prostate Cancer ◽

Prostatectomy Specimen

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Assessment of PSIM (Prostatic Systemic Inflammatory Markers) Score in Predicting Pathologic Features at Robotic Radical Prostatectomy in Patients with Low-Risk Prostate Cancer Who Met the Inclusion Criteria for Active Surveillance

Diagnostics ◽

10.3390/diagnostics11020355 ◽

2021 ◽

Vol 11 (2) ◽

pp. 355

Author(s):

Matteo Ferro ◽

Gennaro Musi ◽

Deliu Victor Matei ◽

Alessandro Francesco Mistretta ◽

Stefano Luzzago ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Active Surveillance ◽

Inflammatory Markers ◽

Low Risk ◽

Inclusion Criteria ◽

Robotic Radical Prostatectomy ◽

Lymphocyte Ratio ◽

Risk Prostate Cancer ◽

Low Risk Prostate Cancer

Background: circulating levels of lymphocytes, platelets and neutrophils have been identified as factors related to unfavorable clinical outcome for many solid tumors. The aim of this cohort study is to evaluate and validate the use of the Prostatic Systemic Inflammatory Markers (PSIM) score in predicting and improving the detection of clinically significant prostate cancer (csPCa) in men undergoing robotic radical prostatectomy for low-risk prostate cancer who met the inclusion criteria for active surveillance. Methods: we reviewed the medical records of 260 patients who fulfilled the inclusion criteria for active surveillance. We performed a head-to-head comparison between the histological findings of specimens after radical prostatectomy (RP) and prostate biopsies. The PSIM score was calculated on the basis of positivity according to cutoffs (neutrophil-to-lymphocyte ratio (NLR) 2.0, platelets-to-lymphocyte ratio (PLR) 118 and monocyte-to-lymphocyte-ratio (MLR) 5.0), with 1 point assigned for each value exceeding the specified threshold and then summed, yielding a final score ranging from 0 to 3. Results: median NLR was 2.07, median PLR was 114.83, median MLR was 3.69. Conclusion: we found a significantly increase in the rate of pathological International Society of Urological Pathology (ISUP) ≥ 2 with the increase of PSIM. At the multivariate logistic regression analysis adjusted for age, prostate specific antigen (PSA), PSA density, prostate volume and PSIM, the latter was found the sole independent prognostic variable influencing probability of adverse pathology.

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