Prostatic Carcinoma: Frequency, Pattern and Evaluation of Gleason Grading in Prostate Biopsies

Abstract

Background: Prostate carcinoma is the second most common cancer and fifth preeminent cause of cancer associated deaths globally in men. Inspite of significant changes in the clinical and histologic diagnosis of prostate carcinoma, the Gleason grading system still remains one of the most powerful prognostic predictors in prostate cancer. The correct diagnosis and grading of prostate carcinoma is critical for a patient’s prognostic and treatment options.
Objective: To determine the frequency and pattern of Prostate cancers in histopathology specimens diagnosed at Dow Diagnostic Research and Reference Laboratory and also to correlate the association of Gleason grade group with histopathological prognostic indicators in Dow University Hospital.
Study type, settings & duration: A retrospective study was conducted in Histopathology section of Dow Diagnostic Research and Reference Laboratory from year 2016 to 2018.
Methodology: Retrospective analysis of all consecutive cases of prostatic adenocarcinoma diagnosed at Histopathology section of Dow Diagnostic Research and Reference Laboratory (DDRRL) for three years between January 1st, 2016 and December 31st, 2018 was done. Statistical analysis was done by using Chi square and Fishers exact test on SPSS version 21 to see the association between Gleason grade group and histopathological prognostic indicators.
Results: A total of 1065 prostate biopsies were analyzed for three years from 2016-2018. Out of them 128 (13%) cases were of prostate adenocarcinoma and 937 (87%) cases were of benign prostatic hyperplasia. The mean age of the patients was 68.9 years and majority (34%) of the cases were in 8th decade of their age. Majority of the tumors (40%) were reported as Gleason grade group 5 on biopsy. In 11% cases carcinoma was an incidental finding as there was no suspicion of carcinoma. There was significant association between Gleason grade group and histopathological prognostic indicators that is perineural invasion and lympho vascular invasion.
Conclusion: Majority of the tumors were in grade group 5 which has increased mortality rate and it indicates that prostate adenocarcinoma is an aggressive disease.