The Role of Histopathologic Grading in the Staging of Localized Prostate Cancer

Abstract

One of the most important parameters in the staging of prostate Cancer is the Gleason Grading, although the Gleason assessed In biopsy is not always the same as the final grading. We have therefore tried to find out whether the use of histopathologic grading might offer some extra information about the biological nature of prostate Cancer. 53 patients underwent a radical open prostatectomy for prostate Cancer. Mean age was 66.16ys; pre-biopsy PSA was 1.92-47 ng/mL. Histopathologic grading was assessed on the biopsy tissue, while grading, Gleason and the pathological stage were assessed on the operation piece. The 53 patients were classified according to their bioptic grading (BG), postoperative grading (PG), stage and PSA. BG=PG in 33 cases (62.26%). 17 patients (30.07%) showed a BG<PG and 3 (3.77%) BG>PG. If we analyze such data according to the stage: 1T1c:GB=GP. 9T2a: 6(66.6%)GB=GP, 2GB<GP and 1GB>GP. 19T2b:10(52.63%)GB=GP, 9(47.3%)GB<GP. 11T2c:11GB=GP. 13T3: 5GB=GP, 6GB<GP and 2GB>>GP. Prostate carcinoma staging still shows a large number of limits related to the unpredictability of neoplasm behaviour. The present trend is to use several parameters. We think that the use of the histopathologic grade can be a useful tool to be added to the ones we already employ. We think histopathologic grading should be used with other grading methods, instead of replacing Gleason, which is still quite effective.