[Concordance evaluation of gleason score between laparoscopic prostatectomy and needle biopsy specimens]

Introduction: Prostate cancer is currently one of the most important health issues especially for developed countries. It is the most common solid organ malignancy amongst men in Europe with 214 new cases per 100.000 men per year and the second most common cause of cancer death. The choice of therapy depends upon the clinical stage (cTNM), PSA level and Gleason histological score. Gleason score of radical prostatectomy specimens is the strongest predictor of disease progression.

Material and methods: Prospective analysis of the pathology reports in 54 patients who underwent TRUS-guided prostate biopsies and subsequent radical prostatectomy in the first department of urology Medical Univeristy in Lodz between 2015-2016. Gleason-score differences were examined for possible correlation with the following factors: age, prostate volume measured by TRUS, preoperative serum PSA level, abnormal digital rectal examination (DRE), pathologic stage (TNM system), positive surgical margins and the presence of metastasis in regional lymph nodes at prostatectomy.

Results: The prostate biopsy and prostatectomy Gleason scores did not differ significantly (>0.05) when compared as a combined score and within the groups of primary and secondary grades. There were no differences in Gleason scores in 66 % of patients. Gleason scores differed by one unit in 13 patients (24%) and by 2 units in 5 patients (9%). There was a correlation between Gleason-score difference (prostatectomy minus biopsy) and positive surgical margin at radical prostatectomy with significantly higher Gleason score difference was higher in patients with positive surgical margin.

Conclusion: There were no significant differences between Gleason score on needle-biopsy and in prostatectomy specimens in the evaluated group of patients.