The role of the pathologist in the evaluation of radical prostatectomy specimens

Objective: To compare the difference between the routinely reported pathology records and the results of re-evaluation of the same radical retropubic prostatectomy (RRP) specimens. Material and Methods: The RRP specimens of 114 patients initially reported by a general pathologist for routine purposes were re-examined and re-evaluated blindly with respect to the following parameters: organ confinement; capsular invasion; seminal vesicle invasion; lymph node metastasis; surgical margin positivity; Gleason grade and pathologic stage. Repeat and step sections were performed where necessary. Prostate mapping was done for each patient. Results: A statistically significant discordance between the routine evaluation and the re-evaluation was observed with regard to capsular invasion, organ confinement, Gleason grade and pathologic stage. In addition to pathologic stage, Gleason grade and surgical margin positivity became significant prognostic factors after the re-evaluation. Conclusions: RRP specimens should be evaluated by an expert prostate pathologist by submitting whole prostate specimens and should include detailed prostate mapping.