title: Correlation between upgrading of prostate biopsy and biochemical failure and unfavorable pathology after radical prostatectomy.
abstract: OBJECTIVE
  To evaluate whether upgrading of the biopsy after radical prostatectomy (RP) affects disease outcome in terms of unfavorable pathology and biochemical failure.
  
  
  METHODS
  We retrospectively evaluated the records of 174 patients who underwent RP. Prostate biopsy and RP specimen Gleason scores (GSs) and correlative clinical data were recorded, and a multivariate analysis was applied.
  
  
  RESULTS
  Overall (138 patients), the disease of 69 men (50.0%) was upgraded, in 19 (13.8%) it was downgraded, and in 50 (36.2%) it had an identical biopsy and pathological GS. Accuracy rates were significantly higher for GS 8-10 compared to low GSs, with a concordance of 50.0 and 12.2%, respectively (p < 0.01). Multivariate analysis revealed the single independent prognostic factor for a non-organ-confined disease as a RP GS 8-10 (p = 0.035). The factors associated with a positive surgical margin were a biopsy GS 8-10 (p < 0.001) and the presence of biopsy score upgrading (p = 0.02). Biopsy GS >or=8 (p < 0.001) and presence of biopsy score upgrading (p = 0.009) were the two independent predictors of relapse after RP.
  
  
  CONCLUSIONS
  This study demonstrated that biopsy upgrading was present in almost half of the patients who underwent RP and it was significantly related to positive surgical margins and biochemical relapse after RP.
authors.affiliation: Department of Urology, Numune Education and Research Hospital, Ankara, Turkey. cuneytozden@hotmail.com
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Ozden
authors.forename: Cetin Volkan
authors.initials: CV
authors.lastname: Oztekin
authors.forename: Ozgur
authors.initials: O
authors.lastname: Ugurlu
authors.forename: Serkan
authors.initials: S
authors.lastname: Gokkaya
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yaris
authors.forename: Ali
authors.initials: A
authors.lastname: Memis
mesh_terms: D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D017211:Treatment Failure
chemical_list: D017430:Prostate-Specific Antigen