Prognostic Factor of Prostate Adenocarcinoma before and after Radical Prostatectomy at a University Hospital

Author(s): Fernando Nestor Facio Junior, Luís Cesar Fava Spessoto, Márcio Gatti, Pedro Francisco Ferraz Arruda, José Germano Ferraz Arruda, Thiago Antoniassi, Maria Fernanda Warick Facio

Introduction: Gleason score is a prognostic factor that assists in the determination of treatment for prostate cancer. The aim of the present study was to investigate the prognostic factor of prostate adenocarcinoma related to the Gleason score before (biopsy) and after radical prostatectomy (RP). Methods: A total of 206 patients with localized prostate adenocarcinoma submitted to RP between 2001 and 2008 at a university hospital were analyzed. Results: The predominant total Gleason score was 6 after biopsy and 7 following RP. The 3+3 pattern after biopsy and 3+4 pattern after RP. Biochemical recurrence was found following RP in 34.9% of cases. In 49% of cases, the Gleason score was lower after biopsy than after RP (p < 0.0005). Considering the group with biochemical recurrence, disagreement was found between the Gleason scores after biopsy and post-radical prostatectomy among 68% of the patients and the Gleason score was lower after biopsy than after post-radical prostatectomy in 18.4% (p = 0.62). Conclusions: The correlation between the Gleason score during prostate biopsy and the score of the specimen submitted to anatomopatological analysis following RP was an important prognostic factor of prostate adenocarcinoma before and after RP and should be considered when choosing the treatment approach.

adenocarcinoma, prostatic neoplasms, prognosis, prostatectomy

1. Altay B, Kefi A, Nazli O, Killi R, Semerci B, Akar I: Comparison of gleason scores from sextant prostate biopsies and radical prostatectomy specimes. Urol Int. 2001; 67: 14-8.
2. Brasil. Instituto Nacional do Câncer (INCA). Estimativa da incidência do câncer de próstata.2010;http://www1.inca.gov.br/estimativa/2010. Fukagai T, Namiki T, Namiki H, Carlile RG, Shimada M, Yoshida H: Discrepancies between Gleason scores of needle biopsy and radical prostatectomy specimens. Pathol Int. 2001; 51.: 364-70.
3. Gregori A, Vieweg J, Dahm P, Paulson DF: Comparison of ultrasound-guided biopsies and prostatectomy specimens: predictive accuracy of Gleason score and tumor site. Urol Int. 2001; 66: 66-71.
4. Humphrey PA: Gleason grading and prognostic factors in carcinoma of the prostate. Mod Pathol. 2004; 17: 292-306.
5. Landis RJ, Koch GG: The measurement of observer agreement for categorical data. Biometrics. 1977; 33: 159-74.
6. Montesino SM, Jiménez AJ, Repáraz RB, Ruiz RM, Hualde Alfaro A, et al: Correlation between Gleason score on prostate biopsies diagnostic of adenocarcinoma and radical prostatectomy specimens. Arch Esp Urol. 2004; 57: 519-23
7. Ohori M, Kattan M, Scardino PT, Wheeler TM: Radical prostatectomy for carcinoma of the prostate. Mod Pathol. 2004; 17: 349-59.
8. Otis WB, Donna PA, Ian MT: Screening Prostate Cancer. CA Cancer J Clin. 2009; 59: 264-73.
9. Prost J, Gros N, Bastide C, Bladou F, Serment G, Rossi D: Correlation between Gleason score of prostatic biopsies and the one of the radical prostatectomy specimen. Prog Urol. 2001; 11: 45-8.
10. Serkin FB, Soderdahl DW, Cullen J, Chen Y, Hernandez J: Patient risk stratification using Gleason score concordance and upgrading among men with prostate biopsy Gleason score 6 or 7. Urol Oncol. 2010; 28: 302-7.
11. Swanson GP, Basler JW: Prognostic factors for failure after prostatectomy. J Cancer. 2011; 2: 1-19.
12. Tavangar SM, Razi A, Mashayekhi R: Correlation between prostate neddle biopsy and radical prostatectomy Gleason gradings of 111 cases with prostatic adenocarcinoma. Urol J. 2004; 1: 246-9.
13. Wolf AM, Wender RC, Etzioni RB, Thompson IM, D’Amico AV, Volk RJ et al: American Cancer Society guideline for the early detection of prostate cancer: update 2010. American Cancer Society Prostate Cancer Advisory Committee. CA Cancer J Clin. 2010; 60: 70-98.