Handling of radical prostatectomy specimens: total or partial embedding?

Area of Science:

• Pathology
• Surgical Oncology

Background:

• Accurate reporting of radical prostatectomy specimens (RPS) is crucial for treatment decisions and prognosis.
• Current practices for handling RPS lack consensus, potentially leading to information loss.

Purpose of the Study:

• To assess if examining only half the horizontal tissue sections of RPS results in significant information loss.
• To evaluate the impact of partial section examination on pathological parameters and patient management.

Main Methods:

• A total of 238 RPS were processed, with horizontal slices sectioned and embedded.
• Every second horizontal slice was withheld during initial microscopic evaluation.
• Pathological parameters were recorded from examined slides, and later compared with full reports.

Main Results:

• A median of 30% of slides were withheld during initial assessment.
• pTNM staging required changes in 3.2% of cases (pT2b to pT2c or pT2c to pT3a).
• Surgical margin status was altered in 0.4% of cases.

Conclusions:

• Systematic partial embedding of RPS results in minimal loss of significant information (1.2%).
• This approach is acceptable for valid histopathological assessment.
• Partial embedding can decrease laboratory workload by 30%.