Abstract

ALGABA ARREA, F.; CHIVITE DE LEON, A.; SANTAULARIA SEGURA, J.Mª  and  OLIVER SAMPER, A.. Evidence of the radical prostatectomy Gleason score in the biopsy Gleason score. Actas Urol Esp [online]. 2004, vol.28, n.1, pp.21-26. ISSN 0210-4806.

INTRODUCTION: The Gleason score (Gs) for prostatic cancer has a good prognosis correlation after radical prostatectomy, for this reason its correlation with the Gs in the biopsy can be useful. PATIENTS AND METHODS: Two hundred fifteen patients with blind evaluation among three pathologists of their Gs in biopsy and in the corresponding radical prostatectomy specimen are presented. RESULTS: The exact coincidence is present in 49.7% of cases, 38.6% of cases are under graded in the biopsy and 11.6% of them over graded in the biopsy. No cases of Gs 2 in the biopsy are found. Any case with Gs 3 and 4 in the biopsy are reproduced in the radical prostatectomy specimen. The exact coincidence for biopsy Gs 5, 6, 7, 8 and 9 are 25%, 45%, 72.7%, 36.6% and 60% respectively (κ 0.32 ± 0.047, p<0.0001 in Gs 5 to 8). The Gleason pattern 4 is the less diagnosed in prostate biopsies (40% of cases with this pattern in the excision specimen it is missing in the biopsy). CONCLUSIONS: The Gs in the needle prostatic biopsy has a good correspondence with the Gs in the radical prostatectomy specimen. For an increase of the reproducibility it is recommendable avoid the diagnosis of Gs 2, 3 and 4 in biopsy and a scrupulous search for the patterns 4 and 5.

Keywords : Prostatic cancer pathology; Gleason system; Needle prostatic biopsy; Radical prostatectomy.

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