The correlation between the Gleason score of a transrectal prostate biopsy and a radical prostatectomy pathological report in patients with localized prostate cancer

Abstract

Background: The Gleason score is a major factor in determining the progress and outcome of a patient who has undergone a radical prostatectomy. There can be a discrepancy between the pre- and post-operative Gleason scores. Knowing the reliability of the Gleason score prior to surgery is a key factor in providing better treatment.

Objective: The purpose of this study is to compare the degree of the histological differentiation of the Gleason score in a transrectal prostate biopsy with the pathological report of the surgical specimen for patients who had a radical prostatectomy operation.

Materials and methods: Of 33 patients who underwent a radical prostatectomy operation were included in a period from January 2009 to January 2014. These patients each had a pathological report of their transrectal needle biopsy (with a minimum of 10 cylinders) and of their radical prostatectomy as the surgical specimen. None of the patients had ever received oncology treatment prior to surgery. The Gleason score was used to observe the degree of differentiation. A comparison was performed between each patient’s Gleason score from the transrectal biopsy and the post-surgical prostate specimen.

Results: In the transrectal biopsy, twenty-three patients (69.7%) received a Gleason score of 6, eight patients (24.2%) had a score of 7, and two patients (6.1%) had an 8. After the radical prostatectomy, fifteen patients (45.4%) showed a Gleason score of 6, eleven patients (33.3%) had a 7, six patients (18.2%) received a score of 8, and one patient (3%) showed a Gleason score of 9. No one received a Gleason score of 10.

Conclusion: Approximately 50% of the pre- and post-operative scores coincide. The transrectal biopsy tends to downgrade the Gleason score grade, as it is reported in the literature.