Gleason Score Correlation Between Prostate Biopsy and Radical Prostatectomy Specimens

Abstract

Objective: Prostate cancer is the most common malignancy in men and the second cause of cancer-related mortality. Prostate biopsy and the Gleason score guide treatment decisions in prostate cancer. Several studies have investigated the correlation between biopsy scores and radical prostatectomy specimen scores. We also evaluated the correlation of Gleason scores of these specimens in our patient series. Materials and Methods: We retrospectively reviewed the data of 468 men who were diagnosed with prostate cancer and underwent radical prostatectomy between 2008 and 2017. Patients’ age, prostate-specific antigen levels at diagnosis, and prostate biopsy and radical prostatectomy specimen Gleason scores were recorded. Upgrading and downgrading were defined as increase or decrease of Gleason score of radical prostate specimen compared to Gleason score of prostate biopsy. Results: A total of 442 men diagnosed with prostate cancer were included in the study. The mean age of the patients was 62.62±6.26 years (44-84 years) and mean prostate specific antigen level was 9.01±6.84 ng/mL (1.09-49 ng/mL). Prostate biopsy Gleason score was <7 in 335 (75.8%) men, 7 in 80 (18.1%) men, and >7 in 27 (6.1%) men. Radical prostatectomy specimen Gleason score was <7 in 267 (60.4%) men, 7 in 113 (25.5%) men and >7 in 62 (14%) men. Gleason correlation was highest in the 240 patients (71.6%) with score <7 and was lowest in the 31 (38.75%) patients with score =7. Conclusion: This study demonstrated that the discordance rate between Gleason scores of prostate biopsy and radical prostatectomy specimens was 35.7%.