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A Multi-Institutional Validation of Gleason Score Derived from Tissue Microarray Cores.

Sami-Ramzi Leyh-Bannurah1,2, Dominique Trudel3,4, Mathieu Latour3,4

  • 1Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada.

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Tissue microarray (TMA) Gleason scores closely agree with radical prostatectomy (RP) findings for high-grade prostate cancer (PCa). TMA accurately predicts biochemical recurrence (BCR) after RP, especially in low-grade cases.

Keywords:
Biochemical recurrenceGleason grade agreementProstate cancerRadical prostatectomyValidation

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Area of Science:

  • Urology
  • Pathology
  • Oncology

Background:

  • Validation of tissue microarray (TMA) findings against radical prostatectomy (RP) pathology is essential for high-grade prostate cancer (PCa) management.
  • TMA's ability to predict biochemical recurrence (BCR) after RP requires further investigation.

Purpose of the Study:

  • To assess the agreement between high-grade PCa identified by TMA and RP.
  • To evaluate TMA's capability in predicting BCR post-RP.
  • To compare the predictive accuracy of RP, TMA, and biopsy for BCR.

Main Methods:

  • Analysis of 1333 multi-institutional Canadian TMA and RP specimens.
  • Testing agreement rates between TMA, RP, and biopsy for high-grade Gleason scores.
  • Utilizing multivariable Cox regression and Kaplan-Meier plots to compare BCR prediction accuracy.

Main Results:

  • Agreement between RP and TMA was 72.6%; between RP and biopsy was 60.4%.
  • Predictive accuracy for BCR was 0.73 for RP, 0.72 for TMA, and 0.68 for biopsy.
  • TMA improved BCR prediction in low-grade Gleason RP patients (p=0.02) but not in high-grade PCa RP patients (p=0.8).

Conclusions:

  • TMA Gleason grade accurately reflects high-grade Gleason in RP specimens.
  • TMA is a reliable predictor of BCR rates following RP.
  • TMA enhances BCR prediction in patients with low-grade Gleason scores at RP.