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Is_The_Biopsy_Gleason_Score_Important_In_Predicting_Outcomes_For_Patients_After_Radical_Prostatectomy.pdf | 2.38 MB |
PURPOSE: To assess the effect of the
biopsy Gleason score(bGS) when controlling for the .patholoqical GS(pGS) on clinical
outcomes in patients undergoing radical prostatectomy.
MATERIAL-METHODS: From April 2001 to July 2008, 59 patients with mean age
of 63.98(range: 51-75) who underwent radical prostatectomy(RP) were enrolled. Preoperative
diagnosis was based on the results of 10 cores transrectal ultrasound guided
biopsy, Each biopsy specimen was assessed for tumor involvement by calculating the
percent of cores positive for cancer, percent of volume involved in all cores
and Gleason score. The correlation between the biopsy findings and the histologic
results at the specimen of RP were investigated, The mean follow up was 14.6 (2-86)
months, Both of the specimens were evaluated by the same pathologist.
RESULTS: The bGS(6.31+0.65) had strongly correlation with that of pGS(6.37+0.56)(p=0.001).
While bGS had correlation with the percentage of positive tissue at the
specimen of RP, bGS failed to show the same correlation with the stage of the disease.
On the contrary, pGS and DRE findings had strongly correlation with the stage of
the disease (p=0.019). Twenty one patients(35.6%) had positive surgical margins
and extracapsular extension. The only preoperative pare meter which had correlation
with postoperative outcomes(PSA free survival) was the percentage of
the
number
of positive cores(p=0.02).
CONCLUSION: There was strongly association between
the bGS and the pGS; the bGS continued to have independent
proqnosuc
influence
after RP and assignment of the pGS. The evaluation of both pathologic specimen
by the same pathologist is recommended.