Interpretation of Prostate Needle Biopsies
Case 13, 14, 15, 16 -
Contemporary Approach to Gleason Grading and Discussion of Other Important Prognostic Markers in the Needle Biopsy Setting (continued)
Rajal Shah and Ming Zhou
Prognostic factors of cancer in needle biopsies: Tumor volume|
Estimating the amount of tumor in needle biopsies (NBX) is another very important prognostic factor to
document. Several studies have demonstrated that tumor amount in NBX correlates with tumor volume at
radical prostatectomy albeit imperfectly, surgical margins, pathologic stage and to a lesser extent with
the Gleason score in radical prostatectomy
It has also shown to predict biochemical
recurrence, post-prostatectomy progression and radiation therapy failure
While the correlation of high tumor burden in NBX is directly proportional to final tumor volume and
adverse outcome, low tumor burden is not necessarily an indicator of low volume and low-stage cancer in
the prostatectomy specimens
The methods of reporting these parameters are not uniform. The report should document the number of
involved cores. In addition, one or both of the following methods of tumor extent should be provided:
the linear length of cancer, or to provide a percentage estimate of involvement of each cores derived by
visual estimate. In cases with extreme fragmentation, composite percentage of involvement would be
approach in such cases. The methods of reporting are summarized in the section of reporting and handling
of the prostate biopsy samples.
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