Correlation of Gleason Scores Between Needle-Core Biopsy and Radical Prostatectomy Specimens in Patients with Prostate Cancer

Background: The histologic grade of a prostate needle-core biopsy specimen can determine whether a patient with prostate cancer is a candidate for radical prostatectomy or other treatment. Incorrect histologic grading can result in inappropriate treatment and possible liability. Thus, we conducted this study to determine the histologic-grading accuracy of prostate cancer needle-core biopsy specimens. Methods: Fifty-two patients with localized prostate cancer treated with radical prostatectomy were included in the study. The overall correlation between Gleason scores for needle-biopsy and prostatectomy specimens was evaluated by analyzing the following parameters: biopsy-core number; accurate biopsy-core length; prostate volume; and preoperative, serum prostate-specific antigen (PSA) level. A “downgrade ” was defined as the Gleason score for the prostatectomy specimen being greater than that for the biopsy specimen, whereas an “upgrade ” was defined as the converse. Results: No difference in Gleason scores was noted for 31 % of specimens, whereas a downgrade was noted for 40%, and an upgrade for 29%. The accuracy of Gleason scores for biopsy specimens taken by the sextant systemic-biopsy method increased when specimens were> 15 mm in length. No correlation was noted between difference in Gleason scores and biopsy-core number, prostate volume, and preoperative serum PSA level. Conclusion: The accuracy of Gleason scores determined by needle biopsy in patients with prostate cancer seem