Correlation between Gleason score of needle biopsy and radical prostatectomy specimen: Accuracy and clinical implications Journal Article

  

Authors:	Cookson, M. S.; Fleshner, N. E.; Soloway, S. M.; Fair, W. R.
Article Title:	Correlation between Gleason score of needle biopsy and radical prostatectomy specimen: Accuracy and clinical implications
Abstract:	Purpose: Despite the reliability of Gleason grading with respect to the same specimen, the correlation between the biopsy and prostatectomy specimen is less well defined. We compared the accuracy of Gleason grading of biopsies in predicting histological grading of radical retropubic prostatectomy specimens. Materials and Methods: Gleason scores of 18 gauge needle biopsies were compared to those of radical retropubic prostatectomy specimens in 226 consecutive patients. In addition to comparing numeric discrepancies, differences between biopsy and specimen Gleason scores of 2 or more and a change in group from Gleason scores 2 to 4, 5 to 7 or 8 to 10 were evaluated by kappa testing, as well as any change in group from Gleason scores 2 to 4, 5 and 6, 7 and 8 to 10. Results: The biopsy score was identical to the specimen score in 31% of cases, while 26% were discrepant by 2 or more Gleason scores. Overall, 54% of biopsies were under graded, while 15% were over graded. If only cases in which discrepancies of 2 or more Gleason scores and a change in group were considered, there was good overall agreement (kappa 0.468, accuracy 80%). Among the cases with any change in group, the accuracy was only 46% with poor agreement (kappa 0.153). Conclusions: Overall, the reliability of Gleason grading of needle biopsies in predicting final pathology was good. However, the limitations of Gleason grading based on biopsy should be considered when discussing treatment options and comparing results based on biopsy data.
Keywords:	adult; human tissue; aged; middle aged; major clinical study; cancer staging; cancer diagnosis; neoplasm staging; diagnostic accuracy; reproducibility of results; biopsy; prostatic neoplasms; prostatectomy; biopsy, needle; needle biopsy; prostate biopsy; scoring system; predictive value of tests; reliability; prostate carcinoma; humans; human; male; priority journal; article
Journal Title:	Journal of Urology
Volume:	157
Issue:	2
ISSN:	0022-5347
Publisher:	Elsevier Science, Inc.
Date Published:	1997-02-01
Start Page:	559
End Page:	562
Language:	English
DOI:	10.1016/s0022-5347(01)65201-7
PUBMED:	8996356
PROVIDER:	scopus
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-0031012744&doi=10.1016%2fS0022-5347%2801%2965201-7&partnerID=40&md5=9a751b21ba6dc20fadfffe35e143df24
Notes:	Article -- Export Date: 17 March 2017 -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/108037