CORRELATION OF TRANSRECTAL ULTRASOUND GUIDED PROSTATE NEEDLE BIOPSY RESULT WITH THE RADICAL PROSTATECTOMY SPECIMEN: COMPARISON OF THE TUMOR LOCATION AND TUMOR GLEASON GRADE

CORRELATION OF TRANSRECTAL ULTRASOUND GUIDED PROSTATE NEEDLE BIOPSY RESULT WITH THE RADICAL PROSTATECTOMY SPECIMEN: COMPARISON OF THE TUMOR LOCATION AND TUMOR GLEASON GRADE
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Title:CORRELATION OF TRANSRECTAL ULTRASOUND GUIDED PROSTATE NEEDLE BIOPSY RESULT WITH THE RADICAL PROSTATECTOMY SPECIMEN: COMPARISON OF THE TUMOR LOCATION AND TUMOR GLEASON GRADE
Author/Abstract:
Aldrin Joseph R. Gamboa, MD; Dennis G. Lusaya, MD and Jason L. Letran, MD

Section of Urology, Department of Surgery, University of Santo Tomas Hospital

Objective: To correlate transrectal ultrasound (TRUS) guided prostate needle biopsy specimens, with emphasis on the location of potentially missed cancer and Gleason grade, with that of the radical retropubic prostatectomy (RRP) specimens. Methodology: A retrospective review was done involving patients who underwent bilateral pelvic lymph node dissection followed by RRP between February 1999 and July 2002. Patient's age, serum prostate specific antigen (PSA) level and tumor location were reviewed. Gleason grading was categorized into three groups: well-differentiated (Gleason 2-4), intermediate (5-7) and poorly differentiated (8-10). Histopathology grading results between needle biopsy and RRP specimens were correlated. Results: Thirty-eight males aged 65.7 + 6.2 with a mean pre-operative PSA of 16.85 were included in the study. Only biopsies of the basal region were consistent in both TRUS and RRP. On the other hand, biopsies of the apical region missed most of the cancers when compared with RRP specimen. TRUS Biopsy and RRP Gleason's Grade (p=0.5997) were comparable. However, it only had a low positive correlation. Finally, a significant (p=0.0082) undergrading of the well-differentiated biopsy specimens was noted. Conclusion: Tumor location on needle biopsy specimens did not correlate well with the final pathology specimens of the RRP. The basal region had the most consistent correlation with the RRP specimens while the apical area had the poorest. Down-grading of the well-differentiated cancers by needle biopsy specimens was observed when compared to the final histopathological result of the RRP specimen.

Key words: Transrectal ultrasound guided needle biopsy, radical retropubic prostatectomy
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