Importance and determinants of Gleason score undergrading on biopsy sample of prostate cancer in a population-based study

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• 作者：Elisabetta Rapiti (1)
  Robin Schaffar (1)
  Christophe Iselin (2)
  Raymond Miralbell (3)
  Marie-Fran?oise Pelte (4)
  Damien Weber (3)
  Roberto Zanetti (5)
  Isabelle Neyroud-Caspar (1)
  Christine Bouchardy (1)
  
• 关键词：Prostate cancer ; Gleason score ; Biopsy ; Prostatectomy ; Population ; based study ; Biopsy undergrading
• 刊名：BMC Urology
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：13
• 期：1
• 全文大小：166KB
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  30. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2490/13/19/prepub
  
• 作者单位：Elisabetta Rapiti (1)
  Robin Schaffar (1)
  Christophe Iselin (2)
  Raymond Miralbell (3)
  Marie-Fran?oise Pelte (4)
  Damien Weber (3)
  Roberto Zanetti (5)
  Isabelle Neyroud-Caspar (1)
  Christine Bouchardy (1)
  
  1. Geneva Cancer Registry, Institute for Social and Preventive Medicine, University of Geneva, 55 boulevard de la Cluse, 1205, Geneva, Switzerland
  2. Division of Urology Surgery, Geneva University Hospitals, rue Gabrielle Perret-Gentil 4, 1211, Geneva 14, Switzerland
  3. Division of Radiation Oncology, Geneva University Hospitals, avenue de la Roseraie 53, 1205, Geneva, Switzerland
  4. Division of Clinical Pathology, Geneva University Hospitals, rue Michel-Servet 1, 1206, Geneva, Switzerland
  5. Piedmont Cancer Registry, CPO, Torino, Italy
  

文摘

Background In this population-based study, we investigated the degree of concordance between Gleason scores obtained from prostate biopsies and those obtained from prostatectomy specimens, as well as the determinants of biopsy understaging. Methods We considered for this study all 371 prostate cancer patients recorded at the Geneva Cancer Registry diagnosed from 2004 to 2006 who underwent a radical prostatectomy. We used the kappa statistic to evaluate the Gleason score concordance from biopsy and prostatectomy specimens. Logistic regression was used to determine the parameters that predict the undergrading of the Gleason score in prostate biopsies. Results The kappa statistic between biopsy and prostatectomy Gleason score was 0.42 (p < 0.0001), with 67% of patients exactly matched, and 26% (n = 95) patients with Gleason score underestimated by the biopsy. In a multi-adjusted model, increasing age, advanced clinical stage, having less than ten biopsy cores, and longer delay between the two procedures, were all independently associated with biopsy undergrading. In particular, the proportion of exact match increased to 72% when the patients had ten or more needle biopsy cores. The main limitation of the study is that both biopsy and prostatectomy specimens were examined by different laboratories. Conclusions The data show that concordance between biopsy and prostatectomy Gleason scores lies within the classic clinical standards in this population-based study. The number of biopsy cores appears to strongly impact on the concordance between biopsy and radical prostatectomy Gleason score.