Comparative Histological Quantification of Prostate Cancer on Surgical Specimens.

Area of Science:

• Uropathology
• Oncology
• Surgical Pathology

Background:

• Prostatic acinar adenocarcinomas (PAA) are diagnosed via biopsy or incidentally during transurethral resection (TURP).
• Histological assessment of prostate specimens is crucial for therapeutic decisions and prognosis.

Purpose of the Study:

• To compare diagnostic differences in tumor type, grade, and invasion between TURP and radical prostatectomy (RP) specimens for PAA.
• To evaluate the sufficiency of TURP for accurate PAA assessment.

Main Methods:

• Analysis of 135 PAA cases diagnosed incidentally or treated curatively.
• Comparison of histological parameters including tumor type, ISUP grade, perineural invasion (IPN), and lymphovascular invasion (LVI) between RP and TURP specimens.

Main Results:

• Specific PAA subtypes (foamy, colloid) were mainly identified on RP, while others (atrophic, pseudohyperplastic) were more common on TURP.
• Higher ISUP grades (3-5) were associated with RP, whereas lower grades (1-2) were more frequent on TURP.
• Perineural invasion (IPN) was found in both, but lymphovascular invasion (LVI) was more prevalent in RP specimens.

Conclusions:

• TURP provides insufficient histological information for a complete evaluation of PAA.
• Targeted biopsies may complement TURP findings for improved diagnostic accuracy, therapeutic decision-making, and prognosis.