Objective: 1. To assess the histopathologic discrepancy between prostatic needle biopsy and open radical prostatectomy specimens in terms of Gleason score upgrading and bilaterality
2. To evaluate the impact of this discrepancy on the surgical margin status of radical prostatectomy specimens Methods: This study was conducted at Prince Hussein Urology Center, Amman, Jordan. Between May 2010 and August 2015, 74 patients underwent open radical prostatectomy for localized prostatic cancer diagnosed by prostatic needle biopsy based on high PSA level. We compared histopathologic findings regarding Gleason score and bilaterality between prostatic biopsy and radical prostatectomy specimens, and then we evaluated the impact discrepancy between them on the surgical margin status of radical prostatectomy specimens.
Results: 52 patients (70%) had upgrade in Gleason score with mean increase by one. All 34 patients who had bilateral disease on prostatic biopsy had bilateral disease on radical prostatectomy, but of the remaining 40 patients with unilateral disease 18 patients (45%) had bilateral disease on radical prostatectomy specimen. Surgical margin was involved in 3 patients (4%), all of them had Gleason score > 7 and bilateral disease on both biopsy and surgical specimens.
Conclusion: In spite of the significant histopathologic discrepancy between prostatic needle biopsy and open radical prostatectomy specimens, however in clinically localized prostatic cancer this discrepancy has no impact on surgical margin status.