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Abstract

Volume 17, Issue 5 (September 2015) 17, 815–820; 10.4103/1008-682X.146970

Gleason score and tumor laterality in radical prostatectomy and transrectal ultrasound-guided biopsy of the prostate: a comparative study

Renan A Pereira, Roberto S Costa, Valdair F Muglia, Fábio França Silva, Joyce S Lajes, Rodolfo B Dos Reis, Gyl EB Silva

1 Department of Pathology, Ribeirao Preto School of Medicine, University of Sao Paulo, São Paulo, Brazil
2 Department of Internal Medicine (Center of Science of Image), Ribeirao Preto School of Medicine, University of Sao Paulo, São Paulo, Brazil
3 Pathology Service, University Hospital of Federal University of Maranhão, São Luís, Maranhão, Brazil
4 University Hospital of Federal University of Maranhão, São Luís, Maranhão, Brazil
5 Department of Surgery and Anatomy, Division of Urology, Ribeirao Preto School of Medicine, University of Sao Paulo, São Paulo, Brazil

Correspondence: Dr. GEB Silva (gyleanes@ig.com.br)

30 January 2015

Abstract

We aimed to compare Gleason score and tumor laterality between transrectal ultrasound-guided biopsy of the prostate (TRUSBX) and radical prostatectomy (RP). Some factors that could cause a discrepancy in results between these two procedures were also evaluated. Among the 318 cases reviewed, 191 cases were selected for inclusion in this comparative study. We divided the patients into two groups using the Gleason score: an intermediate/high-grade group (≥7) and a low-grade group (<6). Exploratory analyses were conducted for comparisons between groups. We also performed comparisons between TRUSBX and RP for tumor laterality. TRUSBX overestimated 6% and underestimated 24% cases in comparison with RP for Gleason score, and overestimated 2.6% and underestimated 46% cases compared with RP for tumor laterality. Biopsy specimens were slightly smaller in TRUSBX cases with underestimated tumor laterality (P < 0.05), and no relationship between the biopsy specimen size and underestimated Gleason score in TRUSBX was found. Prostatic volume showed no statistical correlation with the likelihood of under or overestimation (P > 0.05). Thus, our study showed that TRUSBX has a high likelihood of underestimating both the Gleason score and tumor laterality in prostate cancer (PCa). The size of the fragment appears to be an important factor influencing the likelihood of laterality underestimation and Gleason score overestimation via TRUSBX. Due to the high likelihood of underestimation of the Gleason score and tumor laterality by 12-core prostate biopsy, we conclude that this type of biopsy should not be used alone to guide therapy in PCa.

Keywords: Gleason score; prostate biopsy; prostate carcinoma; prostatectomy; tumor; tumor laterality

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Asian Journal of Andrology CN 31-1795/R ISSN 1008-682X  Copyright © 2023  Shanghai Materia Medica, Chinese Academy of Sciences.  All rights reserved.