Universidad Peruana Cayetano Heredia

Prostate biopsy and radical prostatectomy Gleason score correlation in heterogenous tumors: proposal for a composite Gleason score

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dc.contributor.author Arias-Stella, Javier A. 3rd
dc.contributor.author Shah, Alpa B.
dc.contributor.author Montoya-Cerrillo, Diego
dc.contributor.author Williamson, Sean R.
dc.contributor.author Gupta, Nilesh S.
dc.date.accessioned 2019-02-06T14:53:42Z
dc.date.available 2019-02-06T14:53:42Z
dc.date.issued 2015
dc.identifier.uri https://hdl.handle.net/20.500.12866/5457
dc.description.abstract When prostate biopsy cores are separately identified in multiple containers, current recommendations are to grade each specimen individually. For treatment algorithms, the highest Gleason score (HGS) is typically used as the overall score, even if a lower score predominates. This practice has the potential to misrepresent the overall cancer in the entire gland for some patients and place them in a higher-grade group. We compare a novel composite Gleason score (CGS), integrating grade patterns from contiguous positive biopsy sites, with HGS to determine correlation with the radical prostatectomy (RP) Gleason score (GS). One hundred needle biopsy cases from 2008 to 2012 with >2 GSs in a biopsy set (eg, 3+3=6, 3+4=7, and 4+3=7) or more than a 1-step difference in GS (eg, 3+4=7 and 4+4=8 without 4+3=7) were analyzed. Grades were assigned using both methods (HGS and CGS) and compared with RPGS. Grade groups I to V were used to define downgrade and upgrade. Comparing HGS with RPGS, 31% remained the same and 69% had a change in GS (87% downgraded and 13% upgraded). Comparing CGS with RPGS, 59% remained the same and 41% had a change in GS (10% downgraded and 90% upgraded). Of the 2 methods, the CGS showed better overall correlation with RP (P<0.001) and was less likely to be downgraded compared with HGS. CGS correlates better with RPGS than HGS when >2 grades are present in a biopsy set. CGS has a significantly lower rate of downgrade and predicts the RPGS more accurately than HGS. en_US
dc.language.iso eng
dc.publisher Wolters Kluwer Health
dc.relation.ispartofseries American Journal of Surgical Pathology
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Adult en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Aged en_US
dc.subject Middle Aged en_US
dc.subject Treatment Outcome en_US
dc.subject Reproducibility of Results en_US
dc.subject Lymphatic Metastasis en_US
dc.subject Tumor Burden en_US
dc.subject Predictive Value of Tests en_US
dc.subject Neoplasm Staging en_US
dc.subject Algorithms en_US
dc.subject Biopsy, Large-Core Needle en_US
dc.subject Neoplasm Grading/methods en_US
dc.subject Neoplasm, Residual en_US
dc.subject Prostatectomy/methods en_US
dc.subject Prostatic Neoplasms/pathology/surgery en_US
dc.title Prostate biopsy and radical prostatectomy Gleason score correlation in heterogenous tumors: proposal for a composite Gleason score en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1097/PAS.0000000000000499
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.01.09
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.11
dc.relation.issn 1532-0979


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