Korean J Urol.  2006 May;47(5):482-488. 10.4111/kju.2006.47.5.482.

Concordance of Gleason Scores between Prostate Needle Biopsy and Radical Prostatectomy Specimens according to the Number of Biopsy Cores

• Kim YJ
• Chang IH
• Gil MC
• Hong SK
• Byun SS
• Lee SE

• KMID: 2294131
• DOI: http://doi.org/10.4111/kju.2006.47.5.482

Abstract

PURPOSE
Accurate grading of tumor is critical for administering the correct prostate cancer treatment. Meanwhile, the concordance of Gleason scores (GS) between sextant prostate needle biopsy and the radical prostatectomy (RP) specimen is known to be poor. We investigate if extended needle biopsy could improve the cancer detection rate and GS accuracy.
MATERIALS AND METHODS
A total 826 consecutive patients each underwent 12 core prostate biopsies guided by TRUS. Of these patients, 136 consecutive patients underwent RP. Of the systemic 12 cores, we compared the subset of standard sextant cores, the set of lateral sextant cores and the 12 core set.
RESULTS
The biopsy were positive in 218 cases (26.4%), 213 cases (25.7%) and 265 cases (32%) for the standard sextant, lateral sextant and twelve core biopsy, respectively. Concordance between prostate biopsy and prostatectomy GS was observed in 71 of 104 cases (68.3%), 80 of 110 cases (72.7%) and 98 of 136 cases (72.1%) for the standard sextant, lateral sextant and twelve core biopsy, respectively. Upgrading of 1 or more points was done in 26 of 104 cases (25.0%), 19 of 110 cases (17.3%) and 26 of 136 cases (19.1%), and downgrading 1 or more point was done in 7 of 104 cases (6.7%), 11 of 110 cases (10.0%) and 12 of 136 cases (8.8%) with the standard sextant, lateral sextant and twelve core biopsy, respectively.
CONCLUSIONS
Twelve core needle biopsies lead to a higher cancer detection rate than do the sextant and lateral sextant needle biopsies. Twelve core and lateral sextant needle biopsies lead to higher concordance of the needle biopsy and surgical specimen GS compared with the standard sextant needle biopsy.

Keyword

Biopsy; Prostatic neoplasm; Prostatectomy

MeSH Terms

Biopsy*
Biopsy, Large-Core Needle
Biopsy, Needle*
Humans
Needles*
Prostate*
Prostatectomy*
Prostatic Neoplasms

Figure

• 

  Fig. 1. Coronal prostate plane shows the 12 core biopsy scheme. Filled circles represent standard sextant sites. Open circles represent lateral sextant sites. The broken line represents the mid lobe parasagittal line of the biopsies described by Hodge et al.16

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