Luiza Cavalcanti Fadul1, Mariana Trindade da Silva2, Luiz Antonio Rodrigues de Freitas3, Daniel Abensur Athanazio4. 1. Hospital Universitário Professor Edgard Santos, Rua Augusto Viana sn, Canela, Salvador 40110060, Brazil. 2. Department of Pathology, Faculty of Medicine, Largo do Terreiro de Jesus s/n, Federal University of Bahia, 40025010 Salvador, Brazil. 3. Hospital Universitário Professor Edgard Santos, Rua Augusto Viana sn, Canela, Salvador 40110060, Brazil; Department of Pathology, Faculty of Medicine, Largo do Terreiro de Jesus s/n, Federal University of Bahia, 40025010 Salvador, Brazil; Gonçalo Moniz Research Center, Rua Waldemar Falcão, 121, Oswaldo Cruz Foundation, 40296710 Salvador, Brazil; Imagepat, Pathology Laboratory, Rua Altino Serbeto de Barros 41810570, 119 Salvador, Brazil. 4. Hospital Universitário Professor Edgard Santos, Rua Augusto Viana sn, Canela, Salvador 40110060, Brazil; Department of Pathology, Faculty of Medicine, Largo do Terreiro de Jesus s/n, Federal University of Bahia, 40025010 Salvador, Brazil; Gonçalo Moniz Research Center, Rua Waldemar Falcão, 121, Oswaldo Cruz Foundation, 40296710 Salvador, Brazil. Electronic address: daa@ufba.br.
Abstract
BACKGROUND: Recent data suggest that up to 21% of positive circumferential margins (PCM) and 47% of extraprostatic extension (EPE) samples may be missed when partial embedding methods are employed. Kim and colleagues (2009) suggested that total inclusion of the periphery (3mm rim) of the prostate prevented the failure to detect PCM and EPE. DESIGN: Radical prostatectomy specimen (n=148) slides were reviewed after adoption of a protocol that included a ∼3 mm rim of peripheral tissues. We evaluated whether the analysis of supplemental slides of prostate periphery changed margin status, presence of EPE, Gleason score and extent of PCM and EPE. RESULTS: Partial sampling resulted in missing 29% of PCM and 20% of EPE without using data from the supplemental slides of prostate periphery. Changes from focal to extensive disease were found in 11/21 (52%) cases of positive circumferential margins and in 5/13 (38%) cases of extraprostatic extension. Changes in the Gleason score were uncommon. CONCLUSIONS: These results indicate the importance of including all the prostate peripheral tissue for microscopic analysis when partial embedding methods are adopted.
BACKGROUND: Recent data suggest that up to 21% of positive circumferential margins (PCM) and 47% of extraprostatic extension (EPE) samples may be missed when partial embedding methods are employed. Kim and colleagues (2009) suggested that total inclusion of the periphery (3mm rim) of the prostate prevented the failure to detect PCM and EPE. DESIGN: Radical prostatectomy specimen (n=148) slides were reviewed after adoption of a protocol that included a ∼3 mm rim of peripheral tissues. We evaluated whether the analysis of supplemental slides of prostate periphery changed margin status, presence of EPE, Gleason score and extent of PCM and EPE. RESULTS: Partial sampling resulted in missing 29% of PCM and 20% of EPE without using data from the supplemental slides of prostate periphery. Changes from focal to extensive disease were found in 11/21 (52%) cases of positive circumferential margins and in 5/13 (38%) cases of extraprostatic extension. Changes in the Gleason score were uncommon. CONCLUSIONS: These results indicate the importance of including all the prostate peripheral tissue for microscopic analysis when partial embedding methods are adopted.