Underestimation of Gleason score at prostate biopsy reflects sampling error in lower volume tumours

Abstract

Objective To determine the influence of tumour and prostate gland volumes on the underestimation of prostate cancer Gleason score in diagnostic core biopsies. Patients and Methods Patients undergoing radical prostatectomy with matched diagnostic biopsies were identified from a prospectively recorded database. Tumour volumes were measured in serial whole-mount sections with image analysis software as part of routine histological assessment. Differences in various metrics of tumour and prostate volume between upgraded tumours and tumours concordant for the lower or higher grade were analysed. Results In all, 684 consecutive patients with Gleason score 6 or 7 prostate cancer on diagnostic biops..