Virchows Archiv

, Volume 472, Issue 3, pp 451–460 | Cite as

Digital versus light microscopy assessment of surgical margin status after radical prostatectomy

  • Metka Volavšek
  • Ana Blanca
  • Rodolfo Montironi
  • Liang Cheng
  • Maria R. Raspollini
  • Nuno Vau
  • Jorge Fonseca
  • Francesco Pierconti
  • Antonio Lopez-Beltran
Original Article

Abstract

Positive surgical margin (PSM) extension reported as focal or non-focal/extensive is an important pathologic prognostic parameter after radical prostatectomy. Likewise, there is limited or no agreement on how to measure and what the best cut-off points to be used in practice are. We hypothesized that digital microscopy (DM) would potentially provide a more objective way to measure PSM and better define its clinical significance. To further our knowledge, we have evaluated PSM status in 107 laparoscopic radical prostatectomies using digital and conventional light microscopy (LM). DM evaluation detected three additional PSM cases, but no differences were seen (LM vs DM; p = 0.220). Mean linear measurement correlated to biochemical recurrence (BR) (LM, p = 0.002; DM, p = 0.001). ROC analysis identified a cut-off point to assess linear measurement by LM (3.5 mm) or DM (3.2 mm), but only digital measurement was significant for BR-free survival. Our study also evaluated a cut-off ≤ 3 mm that was associated to BR using LM (p = 0.023) or DM (p = 0.001). Finally, the number of paraffin blocks bearing PSM correlated with BR (p < 0.001) status with either LM or DM. In conclusion, DM produces similar data than LM but shows more accurate measurements. Reporting of PSM with score of ≤ 3 vs. > 3 mm linear extent using LM (3.2 mm if digital microscopy is applied) might represent an important prognostic feature after radical prostatectomy. Alternatively, reporting the number of blocks with PSM 1 vs. 2 or more might also provide important prognostic data in practice.

Keywords

Prostate cancer Radical prostatectomy Surgical margin status Digital microscopy Digital pathology Biochemical recurrence 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Metka Volavšek
    • 1
  • Ana Blanca
    • 2
  • Rodolfo Montironi
    • 3
  • Liang Cheng
    • 4
    • 5
  • Maria R. Raspollini
    • 6
  • Nuno Vau
    • 7
  • Jorge Fonseca
    • 8
  • Francesco Pierconti
    • 9
  • Antonio Lopez-Beltran
    • 10
    • 11
  1. 1.Institute of Pathology, Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
  2. 2.Maimonides Biomedical Research Institute of Cordoba, SpainCordobaSpain
  3. 3.Institute of Pathological Anatomy and Histopathology, School of MedicinePolytechnic University of the Marche Region (Ancona), United HospitalsAnconaItaly
  4. 4.Department of Pathology and Laboratory Medicine, School of MedicineIndiana UniversityIndianapolisUSA
  5. 5.Department of Urology, School of MedicineIndiana UniversityIndianapolisUSA
  6. 6.Histopathology and Molecular DiagnosticsUniversity Hospital CareggiFlorenceItaly
  7. 7.Urologic Oncology, Champalimaud Clinical CenterLisbonPortugal
  8. 8.Urology Clinic, Champalimaud Clinical CenterLisbonPortugal
  9. 9.Division of Anatomic Pathology and HistologyCatholic University of the Sacred Heart, “Agostino Gemelli” School of MedicineRomeItaly
  10. 10.Department of Pathology, Unit of Anatomical Pathology, Department of Surgery, Faculty of MedicineCordobaSpain
  11. 11.Champalimaud Clinical CenterLisbonPortugal

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