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A Multi-Institutional Validation of Gleason Score Derived from Tissue Microarray Cores

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Pathology & Oncology Research

Abstract

To test the agreement between high-grade PCa at RP and TMA, and the ability of TMA to predict BCR. Validation of concordance between tissue microarray (TMA) and radical prostatectomy (RP) high-grade prostate cancer (PCa) is crucial because latter determines the treated natural history of PCa. We hypothesized that TMA Gleason score is in agreement with RP pathology and capable of accurately predicting biochemical recurrence (BCR). Data were provided from a multi-institutional Canadian sample of 1333 TMA and RP specimens with complete clinicopathological data. First, rate of agreement between TMA and high-grade Gleason at RP or biopsy and RP was tested. Second, ability of RP, TMA and biopsy to predict BCR was compared. Multivariable (MVA) Cox regression models were fitted and BCR rates were illustrated with Kaplan-Meier plots. Agreement between RP and TMA and between RP and biopsy was 72.6% (95% CI:69.7–75.5) and 60.4% (95% CI:57.2–63.6), respectively. In MVA predicting BCR, the accuracy for RP, TMA and biopsy was 0.73, 0.72 and 0.68, respectively. TMA added discriminatory ability among exclusively low-grade Gleason RP patients (p = 0.02), but did not improve BCR discrimination in exclusive high-grade PCa RP patients (p = 0.8). TMA Gleason grade accurately reflects presence of high-grade Gleason in RP specimen, accurately predicts BCR rates after RP and improves prediction of BCR in low-grade Gleason patients at RP.

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Acknowledgements

The Network acknowledges contributions to its CPCBN biobank from several Institutions across Canada, namely Centre hospitalier de l’Université de Montreal (CHUM), Centre hospitalier universitaire de Quebec (CHUQ), McGill University Health Centre (MUHC), University Health Network (UHN), University of British Columbia/Vancouver Coastal Health Authority.

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Author notes

  1. Sami-Ramzi Leyh-Bannurah and Dominique Trudel contributed equally to this work.

Authors and Affiliations

  1. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada

    Sami-Ramzi Leyh-Bannurah, Emanuele Zaffuto & Pierre I Karakiewicz

  2. Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany

    Sami-Ramzi Leyh-Bannurah, Markus Graefen & Lars Budäus

  3. Department of Pathology and Cellular Biology, Université de Montréal, Montreal, Canada

    Dominique Trudel & Mathieu Latour

  4. Department of Medecine, Université de Montréal, Montreal, Canada

    Dominique Trudel, Mathieu Latour & Anne-Marie Mes-Masson

  5. Department of Surgery, Université de Montréal, Montreal, Canada

    Fred Saad & Pierre I Karakiewicz

  6. Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Emanuele Zaffuto

  7. Institut du Cancer de Montreal and Centre de recherche du centre hospitalier de l’Université de Montréal, Montreal, QC, Canada

    Andree-Anne Grosset, Christine Tam, Veronique Ouellet, Anne-Marie Mes-Masson & Fred Saad

  8. Research Institute of McGill University Health Center and Department of Surgery (Urology), McGill University, Montreal, QC, Canada

    Armen G. Aprikian

  9. CHU de Québec, Quebec City, Quebec, Canada

    Louis Lacombe

  10. Division of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, ON, Canada

    Neil E. Fleshner

  11. Vancouver Prostate Centre & Department of Urologic Science, University of British Columbia, Vancouver, BC, Canada

    Martin E. Gleave

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  1. Sami-Ramzi Leyh-Bannurah
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  2. Dominique Trudel
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  3. Mathieu Latour
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  5. Andree-Anne Grosset
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  6. Christine Tam
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  7. Veronique Ouellet
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  9. Lars Budäus
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  11. Louis Lacombe
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  14. Anne-Marie Mes-Masson
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  15. Fred Saad
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  16. Pierre I Karakiewicz
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Contributions

All authors of this research paper have directly participated in the planning, execution, or analysis of the study. All authors of this paper have read and approved the final version submitted. The authors listed below have made substantial contributions to the intellectual content of the paper in the various sections described below:

SR Leyh-Bannurah: data analysis, data management, manuscript writing.

D Trudel: data analysis, protocol development, manuscript writing.

M Latour: project development, manuscript editing.

E Zaffuto: manuscript editing, data analysis.

AA Grosset: manuscript editing, data collection.

C Tam: protocol development, project development, data collection.

V Ouellet: protocol development, project development, manuscript editing.

M Graefen: manuscript editing, data analysis.

L Budäus: manuscript editing, manuscript editing.

A Aprikian: project development, data analysis.

L Lacombe: project development, data analysis.

N Fleshner: data analysis, protocol development, manuscript editing.

ME Gleave: protocol development, data collection.

AM Mes-Masson: protocol development, data collection.

F Saad: project development, data collection, data management, manuscript editing.

PI Karakiewicz: project development, data analysis, manuscript writing, manuscript editing.

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Leyh-Bannurah, SR., Trudel, D., Latour, M. et al. A Multi-Institutional Validation of Gleason Score Derived from Tissue Microarray Cores. Pathol. Oncol. Res. 25, 979–986 (2019). https://doi.org/10.1007/s12253-018-0408-6

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