Maybe this explains Gleason Score migration?

[Guest guest]

Friday, 04 January 2008

Division

of Urology, Kobe University

Graduate School

of Medicine, Kobe, Japan

hideakimiyake@...This email address is being protected from

spam bots, you need Javascript enabled to view it

The

objective of this study was to determine whether an increased number of

transrectal biopsy cores improves the accuracy of the biopsy Gleason score.

This

study included a total of 225 patients who were diagnosed as having prostate

cancer by transrectal needle biopsy and subsequently underwent radical

prostatectomy (RP) without neoadjuvant therapy. The rate of grading concordance

between biopsy and RP specimens was analyzed by dividing these patients into 2

groups as follows: group A, 107 patients who underwent transrectal biopsy

sampling of 9 cores or less (median 8 cores), and group B, 118 patients who

underwent biopsy sampling of 10 cores or more (median 12 cores).

Concordance

between the biopsy and RP Gleason scores in group A (53.3%) was significantly

lower than that in group B (69.5%). Upgrading of the biopsy Gleason score in

group A (38.3%) was significantly more frequent than that in group B (21.2%).

Furthermore, these findings tended to be more prominent as the biopsy Gleason

score was lower. Multivariate analysis identified the number of biopsy cores

and percent of positive biopsy cores as independent predictors of accurate

Gleason grading regardless of other parameters examined in this study

These

findings suggest that obtaining a greater number of biopsy cores contributes to

improving the accuracy of the biopsy Gleason score for predicting the RP

Gleason score; therefore, extended sampling of biopsy cores could provide

optimal guidance to determine the therapeutic options in patients with prostate

cancer. © 2007 S. Karger AG, Basel.

Written

by

Miyake H, Kurahashi T, Takenaka A, Hara I, Fujisawa M.

Reference

Urol

Int. 2007;79(4):302-6

doi:10.1159/000109713

PubMed

Abstract

PMID:18025846