Abstract | PURPOSE: The main objective of this retrospective study was to evaluate the influence of pathological experience in histological examination of prostate cancer (PCa) on preoperative understaging (UNS), undergrading (UNG), and upgrading ( UPG). METHODS: Histopathological data of prostate biopsy (PB) and radical prostatectomy (RP) specimens of patients undergoing subsequent radical prostatectomy (n = 430) in our center were compared. Histological diagnoses of PB were provided either by corresponding academic pathology institute (Group 1: 322 patients) or by external (nonacademic) departments which had a lower number (≤ 100/year) of PCa histopathological evaluations (Group 2 108 patients). The rate of UNG, UPG, and UNS in both groups and also the effects of institutional learning curve were analyzed in terms of grading and staging. RESULTS: Significant difference was detected between Group 1 and Group 2 in average preoperative Gleason score (GS) values and in the rate of well, moderately, and poorly differentiated cancers as well. There was also a significant difference in the rate of UNG (29.1 vs. 56.5 %, p < 0.0001). The mean preoperative and postoperative GS in Group 1 was significantly lower in the first 50 than in the last 50 patients, but the rates of UNG, UPG, and UNS did not differ significantly between the groups. CONCLUSIONS: The experience of pathologists has direct influence on grading concordance and on UNG and UPG, between PB and RP specimen; however, it has no significant effect on complete preoperative understaging. The bigger pathological experience improves the sensitivity of the histological diagnostic process.
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Authors | Attila Majoros, Attila Marcell Szász, Péter Nyirády, Eszter Székely, Péter Riesz, Attila Szendrői, Attila Keszthelyi, Janina Kulka, Imre Romics |
Journal | International urology and nephrology
(Int Urol Nephrol)
Vol. 46
Issue 2
Pg. 371-7
(Feb 2014)
ISSN: 1573-2584 [Electronic] Netherlands |
PMID | 23990495
(Publication Type: Journal Article)
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Topics |
- Academic Medical Centers
- Aged
- Biopsy
- Clinical Competence
- Hospitals, High-Volume
- Hospitals, Low-Volume
- Humans
- Learning Curve
- Male
- Middle Aged
- Neoplasm Grading
- Neoplasm Staging
- Pathology, Surgical
(standards)
- Prostate
(pathology)
- Prostatectomy
- Prostatic Neoplasms
(pathology, surgery)
- Retrospective Studies
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