Comparative analysis of sampling methods for grossing radical prostatectomy specimens performed for nonpalpable (stage T1c) prostatic adenocarcinoma

Scant data are available comparing sampling methods of radical prostatectom y specimens performed for clinical stage Tie (nonpalpable) cancer. Seventy- eight stage Tie radical prostatectomies that had 1 or more of the following adverse pathologic findings - Gleason score greater than or equal to7, pos itive margins, and extraprostatic extension - were com pared using 10 diffe rent sampling techniques. Of the 78 entirely submitted cases, 52 had Gleaso n score greater than or equal to7, 14 had positive margins, and 54 had extr aprostatic extension (mean 34 slides). Of the partial sampling methods, we favor the following two methods. The first is submitting every posterior se ction plus 1 midanterior section from right and left sides; if either of th ese anterior sections show sizeable tumor, all ipsilateral anterior slides are examined. This method detects 98% of tumors with Gleason score greater than or equal to7, 100% of positive margins, and 96% of cases with extrapro static extension (mean 27 slides). The second method is to use the above me thod but restrict it to sections ipsilateral to the previous positive needl e biopsy. This method detects 92% of tumors with Gleason score greater than or equal to7, 93% of positive margins, and 85% of cases with extraprostati c extension (mean 17 slides). Partial sampling can detect important prognos tic parameters. By balancing the extra expense and time involved to process and examine additional sections with the risk of missing important prognos tic parameters, pathologists can decide which sampling method to use. Copyr ight (C) 2001 by W.B. Saunders Company.