A Simple Method To Obtain a High Percentage of Fresh Prostate Cancer Tissue from Radical Prostatectomy Specimens without Compromising the Evaluation of Tumor Grade, Stage and Margin Status
Jo-Yu Chen, Ma Khin Than Win, Shu-Jen Chang, Lien-Yen Yang, Mung-Pei Tsai, Yu-Lin Chen, Chih-Ming Liu, Yang-Fang Cheng, Ai-Ying Chuang. Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
Background: Compromising the pathologic evaluation of radical prostatectomy specimens (RPs) during the process of fresh tumor tissue procurement is a major concern. We designed a simple method that achieves a high yield of tumor procurement without compromising the pathologic evaluation.
Design: Immediately after arrival in the pathology department, the prostate was oriented, measured and weighed. A single transverse section of 3-5 mm was made. If there was palpable tumor, the section was taken from that particular area. The capsular area (a distance of 5mm from the prostate surface) was removed and submitted for pathologic examination. The central portion was divided into four quadrants and one piece of fresh tissue (1-2 cm) was taken from each quadrant for tissue harvest. An H&E stained frozen section of each harvested tissue was done for confirming the presence of prostate cancer in tumor repository and Gleason grade for pathologic examination. The remaining prostate tissue, seminal vesicles and vas deferens were totally submitted for pathologic examination.
Results: From 2007 to 2009, a total of 408 fresh tissue fragments were procured from 102 RPs (pT2: 22.5%, pT3a: 52.9%, pT3b: 23.5%, pT4: 1%). There were 6 prostate cancers with previous hormone and/or radiotherapy effect. The yield rate of fresh tumor tissue was 85.3% (87/102). The percentages of tumor area reaching a value of >=25%, >= 50% and >=75% in at least one harvested tissue fragment in these 87 RPs were 80.5%, 57.5% and 34.5%, respectively. Extraprostatic extension was detected in 79 RPs, four (3.9%) of which occurred only at the capsular area from the tumor harvest section. Positive margins were detected in 44 RPs, one of which involved only the capsular area from the tumor harvest section.
Conclusions: Our method is simple and can achieve a high yield (85.3%) for fresh prostate cancer tissue procurement from RPs without compromising pathologic evaluation for clinical patient care. The percentage of procured tumor bulk is remarkable since a yield of >=50% tumor in any single tissue harvest was achieved in approximately 60% RPs. 3.9% of patients would be understaged and 1% of patients would have a false negative margin if the entire capsule had not been submitted for comprehensive pathologic evaluation.
Category: Genitourinary (including renal tumors)
Tuesday, March 5, 2013 9:30 AM
Poster Session III # 71, Tuesday Morning