Turkish Journal of Pathology

Türk Patoloji Dergisi

Turkish Journal of Pathology

Turkish Journal of Pathology

2007, Vol 23, Num, 2     (Pages: 074-081)

Handling and reporting of radical prostatectomy specimens: A practice survey among pathologists


1 Ege University Faculty of Medicine, Department of Pathology, İZMİR
2 St. John Hospital and Medical Center Department of Pathology, İZMİR

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There are controversies on how to best sample and report radical prostatectomy specimens in order to accurately assess prognostic factors. The propensity for obedience to proposed guidelines are controversial likewise. We conducted a survey among Turkish pathologists and residents to assess the attitudes on this issue. Participants were asked about their pathology practice and how they fix, cut and sample the gland or report histologic-based prognostic factors. The results are discussed in the light of the current literature. Fifty-five percent of the 103 participants were studying in centers reporting over 10000 surgical specimens per year, 20% of which were non-university settings. The results showed that submission of whole gland (55%) and volume assessment (25%) were usually practiced in university hospitals (p<0.001 and p=0.02, respectively). Whole mount sectioning was not performed in any center. None of the participants use an alternative grading system, 19% comment upon tertiary Gleason pattern but define it as either the third most frequent pattern (10%) or the highest grade constituting less than 5% of tumor (8%). Prognostic factors of proven significance as Gleason score, extraprostatic extension, vesicula seminalis invasion, and margin status are searched and commented by all respondents while the factors that require validation in multivariate studies are generally assessed by university members.

Keywords : Radical prostatectomy, prognostic factors, tissue sampling, survey, Gleason grading