1.7 post op psa

[Guest guest]

My pre op gleason was3-4. My post op was 6. It has seemed to me that

most post op gleason scores are higher that their pre op. Everything

was supposed to be fine. Nothing outside the capsule. I have been

sceduled for another psa test July 20 with my gp.

[Guest guest]

Well that’s more good news. The

study below shows that the errors on setting Gleason Scores go both ways –

about the same percentage are higher after surgery as those that are lower.

If you are concerned about your PSA why

don’t you have one before 20 July?

BJU International Volume 90 Issue 7 Page

694 - November 2002

Gleason score on biopsy: is it reliable

for predicting the final grade on pathology?

J.-B. Lattouf and F. Saad

Objective To assess the correlation of the

Gleason score on biopsy and the final pathology after radical prostatectomy

(RP) for prostate adenocarcinoma.

Patients and methods In a retrospective

analysis within a tertiary-care centre, the charts of 537 patients who had

undergone radical prostatectomy from April 1989 to November 2000 were reviewed.

The RPs were undertaken in one institution; 167 biopsies were taken and

interpreted in the referring centres, and 355 were taken and interpreted in the

authors' institution by up to 15 pathologists. All the final pathology

specimens were interpreted by the same group of pathologists.

The main outcome measures were: the

pathological report of the biopsy including the primary and secondary Gleason

grade; the final pathological grade (primary and secondary); the margin status;

and the identification of the pathologist for the biopsy and final pathology.

Results In all, 390 patients had inclusion criteria (the Gleason grade before

and after RP) available. For the individual scores 38.2% of tumours were

undergraded, 32.6% overgraded and only 29.2% had identical grading in

preoperative biopsies and final specimens. When grouped into more meaningful

categories (Gleason 2-4, 5-6, 7 and 8-10) the correlation improved, with 48.5%

of patients remaining in the same group after RP. For 39 patients the same

pathologist assessed the biopsy and final specimen; in these cases individual

scores were identical in 49% and group scores were identical in 64%.

Conclusion Gleason grading of the prostate

biopsy remains a poor predictor of pathological outcome. Assessment by the same

pathologist reduces the discrepancy but over half the patients are under- or

overgraded on final pathology. Clinicians should be aware of these limitations

when using the biopsy Gleason grade in decision making.

All the best,

Terry

Herbert in Melbourne, Australia

Diagnosed ‘96: Age

54: Stage T2b: PSA 7.2: Gleason 3+3=6: No treatment. June '07 PSA 35.0

My site is at www.yananow.net

As a

physician, I am painfully aware that most of the decisions we make with regard

to prostate cancer are made with inadequate data: Dr

“Snuffy” Myers.

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of dstalls99

Sent: Saturday, 30 June 2007 5:13

PM

To: ProstateCancerSupport

Subject:

1.7 post op psa

My pre op gleason was3-4. My post op was 6. It has

seemed to me that

most post op gleason scores are higher that their pre op. Everything

was supposed to be fine. Nothing outside the capsule. I have been

sceduled for another psa test July 20 with my gp.

[Guest guest]

As Terry says, why not go ahead and get another blood test for PSA?

Tell your GP what is going on and that you are anxious to find out if

a lab error was made. Ask him to make sure the blood sample is sent to

a different lab than the one that the post op was sent to.

This is a serious thing, and your peace of mind is worth something also.

Where are you located?

Fuller

>

> Well that's more good news. The study below shows that the errors on

setting

> Gleason Scores go both ways - about the same percentage are higher after

> surgery as those that are lower.

>

>

>

> If you are concerned about your PSA why don't you have one before 20

July?

>