Fulda-Graue SD, Hernández-Castellanos VA, Santana-Ríos Zael A, Camarena-Reynoso HR, Cantellano-Orozco M, Morales-Montor JG, Pacheco-Gahbler C, Calderón-Ferro F

Language: Spanish
References: 12
Page: 211-214
PDF size: 3520.06 Kb.

ABSTRACT

Introduction: There have been reports demonstrating an increase in Gleason score of surgical specimen in relation to Gleason score obtained from biopsy in up to 40% of patients that underwent radical prostatectomy. Prostate biopsy risk factors that can increase definitive Gleason score of the surgical specimen are: the presence of intraepithelial neoplasia of the prostate, prostate volume, prostate specific antigen above 10 ng/mL, number of positive biopsy samples, and tumor percentage of the sample. The objective of the present study was to analyze the factors causing Gleason score to be higher in surgical specimen than in biopsy in radical prostatectomy.
Methods: Cases of patients having undergone radical prostatectomy over a period of 18 years were evaluated. The following variables were analyzed in 163 patients: prostate specific antigen, the presence of intraepithelial neoplasia of the prostate, positive biopsy samples, tumor percentage in the positive samples, and prostate volumes. Patients were divided into two groups according to whether there was an increase or not in Gleason score in relation to surgical specimen.
Results: Mean age was 64 years and mean prostate specific antigen was 13 ng/mL. The most frequent Gleason score in surgical specimen was 6. There was no change in Gleason score in 101 patients (61.9%) and there was an increase in Gleason score in 62 patients (38.1%). Prostate specific antigen and tumor percentage in positive biopsy samples showed no statistically significant relation in regard to biopsy Gleason score modification. Prostate volume under 60 g, the presence of intraepithelial neoplasia of the prostate in biopsies, and more than 50% positive samples were statistically significant in regard to higher surgical specimen Gleason score.
Conclusions: The presence of intraepithelial neoplasia of the prostate, prostate volume under 60 g, and more than 50% positive samples in prostate biopsies are factors that may have an influence on surgical specimen Gleason score increase in radical prostatectomy.

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