Concordancia diagnóstica del puntaje de Gleason en biopsia por punción y prostatectomía radical y sus consecuencias clínicas / Concordance of Gleason histological scoring for prostatic cancer in needle biopsies and the surgical piece obtained during radical prostatectomy

ABSTRACT

Background: The Gleason histological score is an independent prognostic factor in prostate cancer that helps in therapeutic decisions. Aim: To analyze the concordance between the Gleason score of needle prostatic biopsy and the score from the study of the surgical piece obtained during radical prostatectomy. Material and methods: Retrospective analysis of 212 cases of prostate cancer, diagnosed between February 1993 and March 2003. All had the Gleason histological scores from needle prostatic biopsies and in the surgical piece obtained during radical prostatectomy. All pathological studies were done by the same observer. Results: There was an exact concordance of Gleason scores between needle biopsy and the surgical piece in 49 percent of cases and a concordance of ± 1 unit in 89 percent. The concordance improved in the second half of the study period. No cases with a Gleason score of less than 5 were detected since 1999 in the surgical piece. Conclusions: The concordance of Gleason score of needle prostatic biopsies and surgical pieces is good. This concordance increases with the experience of the pathologist (Rev Méd Chile 2004; 132 971-8).