Purpose: To assess the effect of the biopsy Gleason score(bGS) when controlling for the pathological GS(pGS) on clinical outcomes in patients undergoing radical prostatectomy.
Material and 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+0.66)(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 parameter 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 prognostic influence after RP and assignment of the pGS. The evaluation of both pathologic specimen by the same pathologist is recommended.