Compatibility of the radical prostatectomy specimen findings with digital rectal examination

The purpose of this research is to evaluate the compatibility of the pathological grading of prostate carcinoma in transrectal biopsy sample (TRUS), Gleason scores 3 + 3 = 6, and a palpable nodule in digital rectal examination (DRE) with radical prostatectomy samples in patients with prostate cancer.

Sixty-one patients with prostate cancer were included. Transrectal biopsy of the prostate and Gleason score were recorded in the histopathological report of the radical prostatectomy sample independently for each patient.

The mean ± standard deviation of PSA level in patients was 8.52 ± 2.23. The average prostate volume was 46.0 ± 12.17 ml. The average density of PSA was 20.06 ± 7.74 ml. The results revealed that 36% of the people after surgery had similar pathology compared to the score before surgery (Gleason score 3 + 3 = 6) while 64% had non-homogeneous reporting (Gleason score 3 + 4 = 7 and other results). The study showed that low prostate volume before surgery was associated with a higher Gleason score after surgery. Although there was no significant relationship between PSA level above 10 before surgery and higher Gleason scores after surgery, there was a statistically significant relationship between PSA density above 15% and higher Gleason scores after surgery (P < 0.001). PSA density was a strong predictor for postoperative Gleason score (P = 0.004).

The high level of PSA density before surgery increased the risk of higher Gleason scores after surgery by 95.99%. Over 64% of the individuals had inconsistency in tumor upgrading, and the palpable firm nodule in the DRE should not be ignored.