Back to Search Start Over

Well-differentiated prostate cancer in core biopsy specimens may be associated with extraprostatic disease

Authors :
José Cury
Rafael Ferreira Coelho
Miguel Srougi
Source :
São Paulo Medical Journal, Vol 126, Iss 2, Pp 119-122
Publisher :
Associação Paulista de Medicina.

Abstract

CONTEXT AND OBJECTIVE: Accurate determination of the Gleason score in prostate core biopsy specimens is crucial in selecting the type of prostate cancer treatment, especially for patients with well-differentiated tumors (Gleason score 2 to 4). For such patients, an inaccurate biopsy score may result in a therapeutic intervention that is too conservative. We evaluate the role of Gleason score 2-4 in prostate core-needle biopsies for predicting the final pathological staging following radical prostatectomy. DESIGN AND SETTING: Retrospective study at Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo. METHODS: We analyzed the medical records of 120 consecutive patients who underwent radical retropubic prostatectomy to treat clinical localized prostate cancer at our institution between December 2001 and July 2006. Thirty-two of these patients presented well-differentiated tumors (Gleason score 2 to 4) in biopsy specimens and were included in the study. The Gleason scores of the core-needle biopsies were compared with the pathological staging of the surgical specimens. RESULTS: Sixteen of the 32 patients (50%) presented moderately differentiated tumors (Gleason score 5 to 7) in surgical specimens. Eighteen patients (56%) had tumors with involvement of the prostate capsule and ten (31%) had involvement of adjacent organs. Evaluating the 16 patients that maintained Gleason scores of 2 to 4 in the pathological staging of the surgical specimens, 11 (68.7%) had focal invasion of the prostate capsule and five (31.25%) had organ-confined disease. CONCLUSION: Well-differentiated tumors (Gleason score 2 to 4) seen in biopsies are not predictive of organ-confined disease.

Details

Language :
English
ISSN :
18069460 and 15163180
Volume :
126
Issue :
2
Database :
Directory of Open Access Journals
Journal :
São Paulo Medical Journal
Publication Type :
Academic Journal
Accession number :
edsdoj.0f55277b6fde4b2ea7453df42260d425
Document Type :
article
Full Text :
https://doi.org/10.1590/S1516-31802008000200010