UroToday - Trends in Gleason Score: Concordance Between Biopsy and Prostatectomy over 15 Years - Abstract

March 22, 2008

Friday, 21 March 2008

Departments of Urology and Pathology, University of Miami School of

Medicine, Miami, Florida

To assess the changes in the concordance rate of prostate biopsy and radical

prostatectomy (RP) Gleason score (GS) over 15 years.

We reviewed 1670 consecutive patients who underwent RP between 1992 and

2006. We excluded patients who underwent neoadjuvant hormone therapy or

salvage RP, or who had incomplete data. Patients who had RP during 1992

through 1996, 1997 through 2001, and 2002 through 2006 were assigned to

groups 1, 2, and 3, respectively. All clinical and pathological data were

collected retrospectively. We defined overgrading as a biopsy GS higher than

the RP Gleason score. Undergrading was a biopsy GS less than the RP Gleason

score. The GS concordance between biopsy and RP was evaluated by kappa

coefficient.

A total of 1363 patients satisfied the inclusion criteria. Biopsy and RP

Gleason score categories correlated exactly in 937 (69%) men. Gleason

undergrading occurred in 361 (26%) men and overgrading in 65 (5%). The exact

correlation of GS between biopsy and RP was 58%, 66%, and 75% in groups 1,

2, and 3, respectively. The most common discordant finding was undergrading

of the biopsy specimen. The number of cases with exact correlation was

highest in GS 7 (78%). Undergrading was more in GS 6 or less (35%) and

overgrading was more in the GS 8 through 10 (35%) category.

This large, single institutional study confirms increasing concordance of

Gleason scores in prostate needle biopsies and surgical specimens. This is

reassuring for patients assessing various treatment options for prostate

cancer.

Written by

Rajinikanth A, Manoharan M, Soloway CT, Civantos FJ, Soloway MS.

Reference

Urology. 2008 Feb 14. Epub ahead of print.

doi:10.1016/j.urology.2007.10.022

PubMed Abstract

PMID:18279938

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