Tertiary Gleason pattern 5 on needle biopsy predicts greater tumour volume on radical prostatectomy

Ranaweera, Matheesha, Samaratunga, Hemamali, Duffy, David, Klopfer, Kiara, Brunelli, Matteo, Martignoni, Guido and Delahunt, Brett (2011) Tertiary Gleason pattern 5 on needle biopsy predicts greater tumour volume on radical prostatectomy. Pathology, 43 7: 693-696. doi:10.1097/PAT.0b013e32834ba487

Author Ranaweera, Matheesha
Samaratunga, Hemamali
Duffy, David
Klopfer, Kiara
Brunelli, Matteo
Martignoni, Guido
Delahunt, Brett
Title Tertiary Gleason pattern 5 on needle biopsy predicts greater tumour volume on radical prostatectomy
Journal name Pathology   Check publisher's open access policy
ISSN 0031-3025
Publication date 2011
Year available 2011
Sub-type Article (original research)
DOI 10.1097/PAT.0b013e32834ba487
Open Access Status
Volume 43
Issue 7
Start page 693
End page 696
Total pages 4
Place of publication Philadelphia, PA United States
Publisher Lippincott Williams and Wilkins
Collection year 2011
Language eng
Subject 2734 Pathology and Forensic Medicine
Abstract Objectives: The modified Gleason system of 2005 recommends incorporating higher grade tertiary patterns on needle biopsy into final Gleason scores to better correlate with radical prostatectomy findings. However, limited literature exists on the validity of this practice and the significance of tertiary Gleason patterns in needle biopsy. Methods: Over a 20 month period there were 25 cases of Gleason score 7 with tertiary pattern 5 on needle biopsy with follow-up radical prostatectomy reported at our institution. Pathological findings at radical prostatectomy from these cases were compared with those from patients with Gleason score 4+3=7 tumours (50 cases) and Gleason score 4+5=9 tumours (63 cases) on needle biopsy. Results: Comparison of Gleason score 4+3=7 with 4+3=7(+5) tumours on needle biopsy, showed a significant difference in tumour volume in the corresponding radical prostatectomy specimen (p=0.02). Differences in patient age, serum prostate specific antigen levels at diagnosis, positive surgical margins, extraprostatic extension, seminal vesicle invasion and lymph node metastases were not statistically significant between the two patient groups or when Gleason score 4+3=7(+5) and Gleason score 9 tumours were compared. Conclusion: Tertiary pattern 5 on needle biopsy predicts greater tumour volume. This suggests that for thin core biopsies, if tertiary pattern 5 is present this should be incorporated into the final Gleason score.
Keyword Adenocarcinoma
Gleason score
International Society of Urological Pathology
Needle biopsy
Radical prostatectomy
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Health and Rehabilitation Sciences Publications
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