Diagnostic Value between 1984 and 2018 of Transrectal Biopsy Guided by Ultrasonography after Radical Prostatectomy

Objectives—to determine correlation between GSs (Gleason scores) on needle biopsy and RP (radical prostatectomy), evaluating diagnostic tests on biopsy and RP within the last years, between 1984 and 2018. Method—analysis of 100 patients, diagnosed with PCa (prostate cancer) needle biopsy using 18-gauge needle, who underwent RP with lymphadenectomy and for which preoperative and postoperative GSs were available. GS group analysis used three categorization schemes for differentiation: mild, moderate and poor for the whole group and we determined SE (sensitivity), SP (specificity), PVPR (positive predictive value), negative predictive value and accuracy. Results—we found that 42% of the patients had no changes between GS on biopsy and prostatectomy, while 20% were overgraded and 38% undergraded by needle biopsy. Graduation of +1 point in GS (32%) or -1 point (17%) was the most common. Most patients were classified as moderately differentiated by biopsies (78 and 35% in scheme 1 and 2 or 3, respectively), while 43% of patients received an intermediate differentiation classification. Biopsy accuracy varied from 44 to 76% for the analysis of all three schemes. Conclusion—there are differences in correlation between GS on biopsy and on surgical specimen, and Gleason's graduation also depends on the experience of the pathologist. We have shown that sextant biopsies using 18-gauge and a same group of pathologists showed acceptable concordance values (42%) between the GS on biopsy and prostatectomy.