Does discontinuous involvement of a prostatic needle biopsy core by adenocarcinoma correlate with a large tumor focus at radical prostatectomy?

Montoya-Cerrillo, Diego; Gupta, Nilesh S.; Varma, Kavita R.; Williamson, Sean R.; Arias-Stella, Javier A. 3rd

dc.contributor.author	Arias-Stella, Javier A. 3rd
dc.contributor.author	Varma, Kavita R.
dc.contributor.author	Montoya-Cerrillo, Diego
dc.contributor.author	Gupta, Nilesh S.
dc.contributor.author	Williamson, Sean R.
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/20.500.12866/5458
dc.description.abstract	When prostate needle biopsies are involved discontinuously by tumor, no consensus remains on the optimal method of tumor quantification. We investigated whether discontinuous biopsy involvement usually results from a large tumor focus or multiple small foci. Prostate needle biopsies with discontinuous tumor and corresponding whole-mounted radical prostatectomies from 2008 to 2013 were analyzed. Linear length and percentage of biopsy involvement were measured both including and subtracting the benign intervening tissue. The corresponding region of the prostatectomy specimen was evaluated for tumor size and multifocality. From over 800 biopsy sets and 400 prostatectomies performed annually, 40 patients met inclusion criteria. Excluding benign tissue, length and percentage of biopsy involvement ranged from 1 to 7 mm and 5% to 66% (median 2.5 mm, 20%), whereas including intervening tissue yielded 4 to 15.5 mm and 25% to 100%, (median 7 mm, 70%), respectively. Benign intervening tissue measured from 2 to 10.5 mm (median 3.5 mm). In 31 patients (78%), a single tumor focus was present in the corresponding region of the prostate (the dominant tumor in 25/31). In 9 patients, multiple small foci were present. Eleven patients could have been excluded from active surveillance eligibility by measuring tumor from end to end (>50% involvement), of whom only 1 met criteria for clinically insignificant cancer at prostatectomy. Discontinuous tumor in a prostate biopsy often results from a single tumor focus in the corresponding region of the prostate (78%). Therefore, we recommend that an end-to-end measurement be provided, with accompanying diagnostic comment that this often correlates with the size of a single tumor focus.	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.subject	Humans	en_US
dc.subject	Male	en_US
dc.subject	Neoplasm Staging	en_US
dc.subject	Biopsy, Large-Core Needle	en_US
dc.subject	Pathology, Surgical	en_US
dc.subject	Adenocarcinoma/pathology	en_US
dc.subject	Neoplasm Grading	en_US
dc.subject	Prostatectomy	en_US
dc.subject	Prostatic Neoplasms/pathology	en_US
dc.title	Does discontinuous involvement of a prostatic needle biopsy core by adenocarcinoma correlate with a large tumor focus at radical prostatectomy?	en_US
dc.type	info:eu-repo/semantics/article
dc.identifier.doi	https://doi.org/10.1097/PAS.0000000000000344
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