Confronto tra Gleason score ottenuto da tessuto prostatico proveniente da agobiopsie multiple ecoguidate vs. corrispondente pezzo operatorio

The aim of this study is to compare the accuracy of the Gleason score of prostate specimens obtained by echo-guided needle biopsies with that of the final histological examination in patients undergoing radical prostatectomy. An assessment was carried out in 2 different centres - Modena and Trieste - on 270 patients subjected to radical prostatectomy for prostate cancer. Age range was between 46 and 76 years. The echo-guided specimens were taken by transperineal and transrectal approach. The resulting Gleason scores were divided into three groups: group I (Gleason 2-4), group II (Gleason 5-7) and group III (Gleason 8-10). An exact correlation between the Gleason score of the biopsy specimens and that of the operative specimens was found in just 30% (105/270) and a correlation between score groups in 73.7% (199/270). The discrepancy between the biopsy and final Gleason score was particularly noticeable in group I. In conclusion, use of the Gleason score obtained from multiple prostate biopsies is unreliable. Our experience is in line with that reported in literature regarding the histopathological heterogeneity of prostate cancer. Given the tolerability of the procedure (whether transperineal or transrectal approach), we consider at least 12 bilateral multiple biopsies should be carried out in addition to the suspect areas in order to improve the correlation.