A Multi-Institutional Validation of Gleason Score Derived from Tissue Microarray Cores

To test the agreement between high-grade PCa at RP and TMA, and the ability of TMA to predict BCR. Validation of concordance between tissue microarray (TMA) and radical prostatectomy (RP) high-grade prostate cancer (PCa) is crucial because latter determines the treated natural history of PCa. We hypothesized that TMA Gleason score is in agreement with RP pathology and capable of accurately predicting biochemical recurrence (BCR). Data were provided from a multi-institutional Canadian sample of 1333 TMA and RP specimens with complete clinicopathological data. First, rate of agreement between TMA and high-grade Gleason at RP or biopsy and RP was tested. Second, ability of RP, TMA and biopsy to predict BCR was compared. Multivariable (MVA) Cox regression models were fitted and BCR rates were illustrated with Kaplan-Meier plots. Agreement between RP and TMA and between RP and biopsy was 72.6% (95% CI:69.7-75.5) and 60.4% (95% CI:57.2-63.6), respectively. In MVA predicting BCR, the accuracy for RP, TMA and biopsy was 0.73, 0.72 and 0.68, respectively. TMA added discriminatory ability among exclusively low-grade Gleason RP patients (p = 0.02), but did not improve BCR discrimination in exclusive high-grade PCa RP patients (p = 0.8). TMA Gleason grade accurately reflects presence of high-grade Gleason in RP specimen, accurately predicts BCR rates after RP and improves prediction of BCR in low-grade Gleason patients at RP.

Pathology oncology research : POR. 2018 Apr 06 [Epub ahead of print]

Sami-Ramzi Leyh-Bannurah, Dominique Trudel, Mathieu Latour, Emanuele Zaffuto, Andree-Anne Grosset, Christine Tam, Veronique Ouellet, Markus Graefen, Lars Budäus, Armen G Aprikian, Louis Lacombe, Neil E Fleshner, Martin E Gleave, Anne-Marie Mes-Masson, Fred Saad, Pierre I Karakiewicz

Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada., Department of Pathology and Cellular Biology, Université de Montréal, Montreal, Canada., Institut du Cancer de Montreal and Centre de recherche du centre hospitalier de l'Université de Montréal, Montreal, QC, Canada., Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany., Research Institute of McGill University Health Center and Department of Surgery (Urology), McGill University, Montreal, QC, Canada., CHU de Québec, Quebec City, Quebec, Canada., Division of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, ON, Canada., Vancouver Prostate Centre & Department of Urologic Science, University of British Columbia, Vancouver, BC, Canada., Department of Medecine, Université de Montréal, Montreal, Canada., Department of Surgery, Université de Montréal, Montreal, Canada.