Özet:

Objective: Prostat biopsy Gleason score is important for treatment planning in patients with localized prostate cancer. Therefore, the concordance between biopsy and radical prostatectomy (RP) pathologies is critically important. However, discordance rates between those two was as 24-50% in the literature. Aim of present study is to evaluate concordance rates between biopsy and RP results. Material and Methods: A retrospective review of 24 patients, who underwent prostate biopsy (standard 12 cores) due to elevated PSA or abnormal digital rectal examination and diagnosed with localized prostate cancer was performed. All patients underwent radical prostatectomy within 8 weeks after biopsy. Associations between preoperative clinical factors and Gleason score upgrading were analyzed. These factors include Gleason scores, percentage of positive cores, age, prostate volume and PSA value.  Gleason upgrading or downgrading was defined as an increase or decrease from one prognostic group to another. Prognostic groups were categorized as GS 6; 7 and 8≤. Results: Median age of patients was68 (58-79) years and median PSA was 9.65 ng/ml (4.2-149). Median prostate volume was 46.5 ml (27-70). Overall, needle biopsies were under-graded in 1 (4.2%) cases, overgraded in 8 (33.3%), and correctly graded in 15 (62.5%) patients. While upgrading was identified in 7 out of 16 (43,5%) patients with GS 6 on needle biopsy, only one patient with GS=7 on biopsy was upgraded. The overall concordance between biopsy and pathological GS was 62.5% (p = 0.025) and k value was 0.31. Independent predictors of upgrading were age (k:0.47 [p=0.01]), PSA> 9 (k:0.50 [p=0.021]) and prostate volume ≥30 cc (k:0.42 [p=0.014]). Conclusion: Although our results were consistent with the literature, new approaches are required to better grading with biopsy.

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