Needle biopsy size and pathological Gleason Score diagnosis: No evidence for a link

Authors

  • Antonio Cicione Urology Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy
  • Francesco Cantiello Urology Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy
  • Cosimo De Nunzio La Sapienza University, Department of Urology, Sant' Andrea Hospital, Rome, Italy
  • Andrea Tubaro La Sapienza University, Department of Urology, Sant' Andrea Hospital, Rome, Italy
  • Rocco Damiano Urology Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy

DOI:

https://doi.org/10.5489/cuaj.311

Keywords:

needle biopsy, Gleason Score, prostate biopsy

Abstract

Background: Biopsy Gleason score (GS), in combination with other clinical parameters, is important to take a therapeutic decision for patients with diagnosis of localized prostate cancer. However, preoperative GS is often upgraded after a radical prostatectomy. Increasing the amount of tissue in prostate biopsy may be a way to avoid this issue. We evaluate the influence of a larger biopsy needle size on the concordance between biopsy and pathological GS.

Methods: We analyzed paired biopsies and prostatectomy specimens from 104 cases of men with clinically localized prostate cancer. At the time of prostate biopsy, the patients were prospectively randomized into two needle groups (16-Gauge [G] and 18G) using a 1:1 ratio. GS concordance was estimated performing kappa statistic testing, overall concordance rate and risk to under grade biopsy GS=6. A logistic regression analysis was performed to evaluate the patients’ characteristics as possible risk factors.

Results: The overall concordance between prostate biopsy and pathological GS was 76.9% and 75.6% (p = 0.875) and the k values were 0.821 and 0.811 (p = 0.424), respectively, for 16G and 18G needle study groups. The risk to undergrade a biopsy GS=6 was 21.1% and 15.4% (p = 0.709) using a 16G and 18G needle, respectively. Age, prostate-specific antigen, prostate volume and needle calibre were not independently associated with a higher risk of GS discordance.

Conclusions: Needle size does not affect the concordance between biopsy and pathological GS. Although GS is not the only way to determine treatment, it is still an unresolved urological issue.

Downloads

Download data is not yet available.

Downloads

Published

2013-09-10

How to Cite

Cicione, A., Cantiello, F., De Nunzio, C., Tubaro, A., & Damiano, R. (2013). Needle biopsy size and pathological Gleason Score diagnosis: No evidence for a link. Canadian Urological Association Journal, 7(9-10), e567–71. https://doi.org/10.5489/cuaj.311

Issue

Vol. 7 No. 9-10 (2013): CUAJ September

Section

Original Research

License

You, the Author(s), assign your copyright in and to the Article to the Canadian Urological Association. This means that you may not, without the prior written permission of the CUA:

  • Post the Article on any Web site
  • Translate or authorize a translation of the Article
  • Copy or otherwise reproduce the Article, in any format, beyond what is permitted under Canadian copyright law, or authorize others to do so
  • Copy or otherwise reproduce portions of the Article, including tables and figures, beyond what is permitted under Canadian copyright law, or authorize others to do so.

The CUA encourages use for non-commercial educational purposes and will not unreasonably deny any such permission request.

You retain your moral rights in and to the Article. This means that the CUA may not assert its copyright in such a way that would negatively reflect on your reputation or your right to be associated with the Article.

The CUA also requires you to warrant the following:

  • That you are the Author(s) and sole owner(s), that the Article is original and unpublished and that you have not previously assigned copyright or granted a licence to any other third party;
  • That all individuals who have made a substantive contribution to the article are acknowledged;
  • That the Article does not infringe any proprietary right of any third party and that you have received the permissions necessary to include the work of others in the Article; and
  • That the Article does not libel or violate the privacy rights of any third party.