Complete embedding and close step-sectioning of radical prostatectomy specimens both increase detection of extraprostatic extension, and correlate with increased disease-free survival by stage of prostate cancer patients

A. Desai, H. Wu, L. Sun, I. A. Sesterhenn, F. K. Mostofi, D. McLeod, C. Amling, L. Kusuda, R. Lance, J. Herring, J. Foley, D. Baldwin, J. T. Bishoff, D. Soderdahl, J. W. Moul

Research output: Contribution to journalArticlepeer-review

31 Scopus citations

Abstract

The objectives of this work were to evaluate the efficacy of controlled close step-sectioned and whole-mounted radical prostatectomy specimen processing in prediction of clinical outcome as compared to the traditional processing techniques. Two-hundred and forty nine radical prostatectomy (RP) specimens were whole-mounted and close step-sectioned at caliper-measured 2.2-2.3 mm intervals. A group of 682 radical prostatectomy specimens were partially sampled as control. The RPs were performed during 1993-1999 with a mean follow-up of 29.3 months, pretreatment PSA of 0.1-40, and biopsy Gleason sums of 5-8. Disease-free survival based on biochemical or clinical recurrence and secondary intervention were computed using a Kaplan-Meier analysis. There were no significant differences in age at diagnosis, age at surgery, PSA at diagnosis, or biopsy Gleason between the two groups (P < 0.05). Compared with the non-close step-sectioned group, the close step-sectioned group showed higher detection rates of extra-prostatic extension (215 (34.1%) vs, 128 (55.4%), P < 0.01), and seminal vesicle invasion (50 (7.6%) vs 35 (14.7%), P < 0.01). The close step-sectioned group correlated with greater 3-y disease-free survival in organ-confined (P < 0.01) and specimen-confined (P < 0.01) cases, over the non-uniform group. The close step-sectioned group showed significantly higher disease-free survival for cases with seminal vesicle invasion (P = 0.046). No significant difference in disease-free survival was found for the positive margin group (P = 0.39) between the close step-sectioned and non-uniform groups. The close step-sectioned technique correlates with increased disease-free survival rates for organ and specimen confined cases, possibly due to higher detection rates of extra-prostatic extension and seminal vesicle invasion. Close step-sectioning provides better assurance of organ-confined disease, resulting in enhanced prediction of outcome by pathological (TNM) stage.

Original languageEnglish (US)
Pages (from-to)212-218
Number of pages7
JournalProstate Cancer and Prostatic Diseases
Volume5
Issue number3
DOIs
StatePublished - 2002
Externally publishedYes

Keywords

  • Close step-sectioning
  • Pathology
  • Prostatectomy
  • Prostatic neoplasms
  • Tissue sampling
  • Whole mount

ASJC Scopus subject areas

  • Oncology
  • Urology
  • Cancer Research

Fingerprint Dive into the research topics of 'Complete embedding and close step-sectioning of radical prostatectomy specimens both increase detection of extraprostatic extension, and correlate with increased disease-free survival by stage of prostate cancer patients'. Together they form a unique fingerprint.

Cite this