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Summary: The Gleason score obtained on prostatic biopsies is a key parameter in the management of localized prostate cancer.
Objectives: We conducted this study to evaluate the correlation between Gleason scores (GS) obtained on prostate biopsies and radical prostatectomy to establish the accuracy of biopsy grading in the prediction of final grades.
Materials and Methods: Forty patients with localized prostate cancer diagnosed between 2000 and 2010, and treated with radical prostatectomy, were included in this study. All patients underwent transrectal needle biopsies (TRNB) with at least 12 cores. Gleason scores on biopsies and radical prostatectomy specimens were determined and the concordance between the 2 scores was then evaluated. Histological grading using the conventional Gleason grading system (3 groups) and the modified Gleason grading system (5 groups) was also performed. The correlation between grades obtained on biopsies and radical prostatectomy specimens was also evaluated.
Results: The mean age of patients was 61.1 years, with a mean PSA value of 10 ng/ml. In 32.5% of cases, the biopsy’s Gleason score correlated with the one obtained on radical prostatectomy. Using the conventional Gleason grading system, the correlation highly improved, with 62.5% of patients remaining in the same group after radical prostatectomy. However, using modified Gleason grading, the correlation was slightly improved and estimated at 37%.
Conclusion: In this study we have noticed that the accuracy of Gleason scores determined by transrectal needle biopsy in patients with prostate cancer seems unreliable. The classification of patients into 3 distinct groups (well, moderately, and poorly differentiated tumors) increases the concordance between the biopsy GS and the definitive GS, but the modified Gleason grading system seems to be more precise and better reflects the Gleason score.
Sallami Satáa, Ines Chelly, Amira Ben Salem, Hanen Chorfi, Haifa Nfoussi, Nidhameddine Kchir
Submitted June 11, 2012 - Accepted for Publication July 9, 2012
KEYWORDS: Prostate carcinoma, prostate biopsy, radical prostatectomy, pathology, Gleason score
CORRESPONDENCE: Sallami Satáa, MD, La Rabta Hospital-University, Tunis, Tunis, Tunisia (firstname.lastname@example.org)
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