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Complete embedding and close step-sectioning of radical prostatectomy specimens both increase detection of extra-prostatic extension, and correlate with increased disease-free survival by stage of prostate cancer patients

Prostate Cancer and Prostatic Diseases volume 5, pages 212–218 (2002)Cite this article

Abstract

The objectives of this work were to evaluate the efficacy of controlled close step-sectioned and whole-mounted radical prostatectomy specimen processing in prediction of clinical outcome as compared to the traditional processing techniques. Two-hundred and forty nine radical prostatectomy (RP) specimens were whole-mounted and close step-sectioned at caliper-measured 2.2–2.3 mm intervals. A group of 682 radical prostatectomy specimens were partially sampled as control. The RPs were performed during 1993–1999 with a mean follow-up of 29.3 months, pretreatment PSA of 0.1–40, and biopsy Gleason sums of 5–8. Disease-free survival based on biochemical or clinical recurrence and secondary intervention were computed using a Kaplan-Meier analysis. There were no significant differences in age at diagnosis, age at surgery, PSA at diagnosis, or biopsy Gleason between the two groups (P<0.05). Compared with the non-close step-sectioned group, the close step-sectioned group showed higher detection rates of extra-prostatic extension (215 (34.1%) vs, 128 (55.4%), P<0.01), and seminal vesicle invasion (50 (7.6%) vs 35 (14.7%), P<0.01). The close step-sectioned group correlated with greater 3-y disease-free survival in organ-confined (P<0.01) and specimen-confined (P<0.01) cases, over the non-uniform group. The close step-sectioned group showed significantly higher disease-free survival for cases with seminal vesicle invasion (P=0.046). No significant difference in disease-free survival was found for the positive margin group (P=0.39) between the close step-sectioned and non-uniform groups. The close step-sectioned technique correlates with increased disease-free survival rates for organ and specimen confined cases, possibly due to higher detection rates of extra-prostatic extension and seminal vesicle invasion. Close step-sectioning provides better assurance of organ-confined disease, resulting in enhanced prediction of outcome by pathological (TNM) stage.

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Acknowledgements

The opinions and assertions contained herein are the private views of the authors and are not to be construed as representing the views of the United States Army or Department of Defense.

This research was supported by the Department of Defense Center for Prostate Disease Research (CPDR), a program funded by the US Army Medical Research and Material Command (USAMRMC) through the Uniformed Services University (USU) and administered by the Henry M. Jackson Foundation for the Advancement of Military Medicine.

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Authors and Affiliations

  1. Center for Prostate Disease Research (CPDR), Rockville, Maryland, USA

    A Desai, H Wu, L Sun, D McLeod & J W Moul

  2. Uniformed Services University of the Health Sciences (Department of Surgery), Rockville, Maryland, USA

    L Sun, D McLeod & J W Moul

  3. Armed Forces Institute of Pathology, USA

    I A Sesterhenn & F K Mostofi

  4. Walter Army Medical Center, USA

    D McLeod & J W Moul

  5. San Diego Naval Medical Center, USA

    C Amling

  6. Portsmouth Naval Medical Center, USA

    L Kusuda

  7. Madigan Army Medical Center, USA

    R Lance

  8. National Naval Medical Center, USA

    J Herring

  9. Brooke Army Medical Center, USA

    J Foley

  10. Malcolm Grow Medical Center, USA

    D Baldwin

  11. Wilford Hall Medical Center, USA

    J T Bishoff

  12. Eisenhower Army Medical Center, USA

    D Soderdahl

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  1. A Desai
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Correspondence to J W Moul.

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Desai, A., Wu, H., Sun, L. et al. Complete embedding and close step-sectioning of radical prostatectomy specimens both increase detection of extra-prostatic extension, and correlate with increased disease-free survival by stage of prostate cancer patients. Prostate Cancer Prostatic Dis 5, 212–218 (2002). https://doi.org/10.1038/sj.pcan.4500600

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