Radical prostatectomy – analysis of 191 cases examined using whole-mount section method

Česká verzia

Authors: Kristýna Pivovarčíková ¹; Jindřich Branžovský ¹; Kevin Bauleth ¹; Ivan Trávníček ²; Olga Dolejšová ²; Alžběta Šobrová ²; Viktor Eret ²; Jiří Ferda ³; Milan Hora ²; Ondřej Hes ¹
Authors place of work: Oddělení speciální diagnostiky Šiklův patologicko-anatomický ústav FN a LF, Plzeň ¹; Urologická klinika FN a LF, Plzeň ²; Klinika zobrazovacích metod FN a LF, Plzeň ³
Published in the journal: Ces Urol 2014; 18(1): 26-32
Category: Original article

Summary

Aim:
This work aims to present the advantages of histological processing using whole-mount sections (WMS) and to compare it with other methods commonly used for evaluation of tissue removed during the course of a radical prostatectomy (RP).

Material and methods:
All cases of carcinoma of the prostate, treated by radical prostatectomy, and processed using WMS, August 2009 to March 2013 were histologically re-evaluated. The following parameters were analyzed: histological type, Gleason score, presence of a tumour in the apex, multicentricity, infiltration of the seminal vesicles, presence of positive resection margins and extracapsular extension.

Results:
There were 191 RP specimens processed with WMS. Histological diagnosis of acinar prostatic adenocarcinoma was made in 97.4% of cases. The most frequent Gleason score was 6 (3 + 3) in 42.9%. In 20.4%, the tumour was multicentric. Invasion of the apex was found in 127 cases. The extracapsular extension was detected in 20.9%. The metastatic infiltration of the lymph nodes was registered in 2.1%. The presence of positive resection margins in the specimen was detected in 36.1%. Infiltration of seminal vesicles was present in 12.0%. Invasion of the neural-vascular bundle was detected in 3.7% and invasion of the striated muscle of the external sphincter in 3.1% of cases.

Conclusions:
WMS allows precise determination of the disease stage and Gleason score. It also facilitates precise detection of positive surgical margins. The routine use of WMS can be recommended in histopathological diagnostics of prostate cancer due to its obvious benefits for the patient.

Key words:
prostate, prostate cancer, adenocarcinoma, whole-mount section, staging.

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