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Clinical Medicine Insights: Pathology

Impact of Pathology Review for Decision Therapy in Localized Prostate Cancer

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Clinical Medicine Insights: Pathology 2017:10 1179555717740130

Short Report

Published on 02 Nov 2017

DOI: 10.1177/1179555717740130


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Abstract

Background:

The Gleason score is an essential tool in the decision to treat localized prostate cancer. However, experienced pathologists can classify Gleason score differently than do low-volume pathologists, and this may affect the treatment decision. This study sought to assess the impact of pathology review of external biopsy specimens from 23 men with a recent diagnosis of localized prostate cancer.

Methods:

All external biopsy specimens were reviewed at our pathology department. Data were retrospectively collected from scanned charts.

Results:

The median patient age was 63 years (range: 46-74 years). All patients had a Karnofsky performance score of 90% to 100%. The median prostate-specific antigen level was 23.6 ng/dL (range: 1.04-13.6 ng/dL). Among the 23 reviews, the Gleason score changed for 8 (35%) patients: 7 upgraded and 1 downgraded. The new Gleason score affected the treatment decision in 5 of 8 cases (62.5%).

Conclusions:

This study demonstrates the need for pathology review in patients with localized prostate cancer before treatment because Gleason score can change in more than one-third of patients and can affect treatment decision in almost two-thirds of recategorized patients.



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