title: Biopsy characteristics in men with a preoperative diagnosis of prostatic adenocarcinoma with high Gleason score (8-10) predict pathologic outcome in radical prostatectomy.
abstract: Even if limited to one biopsy core, most urologists and radiation oncologists use the highest Gleason score (GS) to guide therapy. To evaluate the suitability of using biopsy characteristics to predict tumor characteristics at radical prostatectomy (RP) in men with high biopsy GS (BGS) cancer to better select men who will most benefit from various local therapies, we retrospectively reviewed the biopsy and RP findings of 144 men with a BGS 8-10. One hundred six and 38 patients with a BGS of 8 and 9-10, respectively, were included. Forty-eight percent of cases were downgraded to a final GS of 7 at RP, including 54% of BGS 8, and 32% of BGS 9-10 group. Overall, 31% had pT2 disease at RP. Multiple biopsy features, including the GS, the number of positive cores, the number of cores with high-GS cancer, and the maximum volume of high-grade cancer per core (MVPC) consistently predicted final GS and RP tumor stage. Multivariate analysis showed that biopsy GS and MVPC were independent predictors of final GS, while MVPC was also an independent predictor for final pT stage. Patients with high BGS are not a homogeneous group in terms of local tumor characteristics. In addition to BGS (9-10 being worse than 8), other biopsy findings, especially the number of involved cores, number of cores with high-BGS cancer, and MVPC are important predictors of findings at RP that should be incorporated in the decision treatment planning. Most patients with only one core BGS 8 cancer harbor GS 7 cancer.
authors.affiliation: Department of Pathology, McGill University, Montréal, QC, Canada H3G1A4. Electronic address: fadi.brimo@muhc.mcgill.ca.
authors.forename: Fadi
authors.initials: F
authors.lastname: Brimo
authors.affiliation: Department of Pathology, McGill University, Montréal, QC, Canada H3G1A4.
authors.forename: Bin
authors.initials: B
authors.lastname: Xu
authors.affiliation: Department of Pathology, McGill University, Montréal, QC, Canada H3G1A4.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Scarlata
authors.affiliation: Department of Pathology, Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada H4J1C5.
authors.forename: Louis R
authors.initials: LR
authors.lastname: Bégin
authors.affiliation: Department of Pathology, McGill University, Montréal, QC, Canada H3G1A4.
authors.forename: Alan
authors.initials: A
authors.lastname: Spatz
authors.affiliation: Department of Urology, CHU Henri-Mondor, Créteil 94010, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Salomon
authors.affiliation: Department of Urology, McGill University, Montréal, QC, Canada H3G1A4.
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: Zakaria
authors.affiliation: Department of Urology, McGill University, Montréal, QC, Canada H3G1A4.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Ploussard
authors.affiliation: Department of Urology, McGill University, Montréal, QC, Canada H3G1A4.
authors.forename: Frank
authors.initials: F
authors.lastname: Bladou
authors.affiliation: Department of Urology, McGill University, Montréal, QC, Canada H3G1A4.
authors.forename: Wassim
authors.initials: W
authors.lastname: Kassouf
authors.affiliation: Department of Urology, McGill University, Montréal, QC, Canada H3G1A4.
authors.forename: Simon
authors.initials: S
authors.lastname: Tanguay
authors.affiliation: Department of Urology, McGill University, Montréal, QC, Canada H3G1A4.
authors.forename: Simone
authors.initials: S
authors.lastname: Chevalier
authors.affiliation: Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA 2215.
authors.forename: Huihui
authors.initials: H
authors.lastname: Ye
authors.affiliation: Department of Urology, McGill University, Montréal, QC, Canada H3G1A4.
authors.forename: Armen
authors.initials: A
authors.lastname: Aprikian
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000368:Aged; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies
keywords: Biopsy; Core; Correlation; Gleason 8-10; Prostatectomy; Prostatic adenocarcinoma