Staging of Prostatic Adenocarcinoma with Radical Prostatectomy Specimens in Pakistan

Objectives: Data for pathological staging of radical prostatectomy specimens reported in the Section ofHistopathology of a large tertiary care hospital in Pakistan were compared with sextant biopsy findings todetermine whether clinically localized disease is actually localized pathologically. Design: A study was conductedof radical prostatectomy specimens reported in the Section of Histopathology from Jan 2001 to July 2008, withcases staged according to the pathologic TNM staging system. Other variables such as amount of tumor inprostatectomy specimens and lobes affected were also determined.
Results: Out of 65 cases, 83.3% were clinicalstage TIc. 29.2% were pT3a, 24.6% were pT3b and 3.1% were pT4. Therefore, in the majority of cases, diseasewas not localized to the prostate and perineurial invasion was seen in all. Comparison with biopsy results showedGleason’s grade to be altered in 20% cases.
Conclusions:The large majority of prostatic carcinomas in Pakistanare advanced cancers with pathologic stage more advanced than evident on clinical staging. On average,tumors involved 35-40% of the prostate with a particular preponderance in posterior lobes.