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Digital versus light microscopy assessment of extraprostatic extension in radical prostatectomy samples

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Abstract

Focal or non-focal/extensive extraprostatic extension of prostate carcinoma is an important pathologic prognostic parameter to be reported after radical prostatectomy. Currently, there is no agreement on how to measure and what are the best cutoff points to be used in practice. We hypothesized that digital microscopy would potentially provide more objective measurements of extraprostatic extension, thus better defining its clinical significance. To further our knowledge on digital prostate pathology, we evaluated the status of extraprostatic extension in 107 consecutive laparoscopic radical prostatectomy samples, using digital and conventional light microscopy. Mean linear and radial measurements of extraprostatic extension by digital microscopy significantly correlated to pT status (p = 0.022 and p = 0.050, respectively) but only radial measurements correlated to biochemical recurrence (p = 0.042) and grade groups (p = 0.022). None of the measurements, whether conventional or digital, were associated with lymph node status. Receiving operating characteristic analysis showed a potential cutoff point to assess linear measurements by conventional (< vs. > 24.21 mm) or digital microscopy (< vs. > 15 mm) or by radial measurement (< vs. > 1.6 mm). Finally, we observed an association between the number of paraffin blocks bearing EPE with pT (p = 0.041) status (digital microscopy), and linear measurements by conventional (p = 0.044) or digital microscopy (p = 0.045) with lymph node status. Reporting EPE measurements by digital microscopy, both linear and radial, and the number of paraffin blocks with EPE, might provide additional prognostic features after radical prostatectomy.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

    Metka Volavšek

  2. Pathology Service, Champalimaud Clinical Center, Lisbon, Portugal

    Vanessa Henriques

  3. Maimonides Biomedical Research Institute of Cordoba, Cordoba, Spain

    Ana Blanca

  4. Institute of Pathological Anatomy and Histopathology, School of Medicine, Polytechnic University of the Marche Region (Ancona), United Hospitals, Ancona, Italy

    Rodolfo Montironi & Alessia Cimadamore

  5. Departments of Pathology and Laboratory Medicine and Urology, School of Medicine, Indiana University, Indianapolis, IN, USA

    Liang Cheng

  6. Histopathology and Molecular Diagnostics, University Hospital Careggi, Florence, Italy

    Maria R. Raspollini

  7. Urologic Oncology, Champalimaud Clinical Center, Lisbon, Portugal

    Nuno Vau

  8. Division of Anatomic Pathology and Histology, Catholic University of the Sacred Heart, “Agostino Gemelli” School of Medicine, Rome, Italy

    Francesco Pierconti

  9. Department of Pathology, Unit of Anatomical Pathology, Department of Surgery, Faculty of Medicine, Cordoba, Spain and Champalimaud Clinical Center, Lisbon, Portugal

    Antonio Lopez-Beltran

  10. Cordoba, Spain

    Antonio Lopez-Beltran

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  1. Metka Volavšek
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Contributions

ALB, MV, and VH conceived and designed the study and wrote, edited, and reviewed the manuscript. AB performed the statistical analysis and reviewed the manuscript. AC, MRR, NV, VH, FP, and ALB collected and analyzed data and reviewed the manuscript. RM and LC critically read and edited the final manuscript. All authors gave final approval for publication.

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Written informed consent was obtained from all patients included in the study.

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Volavšek, M., Henriques, V., Blanca, A. et al. Digital versus light microscopy assessment of extraprostatic extension in radical prostatectomy samples. Virchows Arch 475, 735–744 (2019). https://doi.org/10.1007/s00428-019-02666-x

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