Comparative Histological Quantification of Prostate Cancer on Surgical Specimens

Prostatic acinar adenocarcinomas (PAA) are frequently diagnosed by biopsy, but sometimes they can be identified incidentally on transurethral resection (TURP) tumor fragments. The classical histological information provided by resection and prostate biopsy specimens is the basis for the therapeutic approach and the establishment of the prognosis of the tumors. In this study, we analyzed 135 PAA that were diagnosed incidentally or for which curative therapy was practiced, for which we established the diagnostic differences for tumor type, tumor grade, presence of perineural (IPN) and lymphovascular invasion (LVI) on radical prostatectomy (RP) and TURP specimens. The tumor type, especially foamy PAA (FPAA) and colloid PAA (CoPAA) were identified mainly on PR, while atrophic PAA (APAA), and pseudohyperplastic PAA (PPAA) mainly on TURP. High ISUP 3-5 grading groups were associated mainly with RP, while ISUP 1-2 were more frequently present on TURP. IPN was present in both types of specimens, while the presence of LVI was more frequent on RP. For the most accurate evaluation of the histological parameters associated with PAA, the information provided by TURP seems insufficient and can be complemented by targeted biopsies for the accuracy of the therapeutic decision and prognosis.