Histopathological Analysis
The histopathological analysis of the biopsy materials was performed by an experienced uropathologist (F.T.). The reports were structured in accordance with the 2016 the International Society of Urological Pathology (ISUP) Gleason grading system (2). The pathological long-axis diameter of the lesion on the specimens and the biopsy core numbers for the pathologic lesions were also recorded.
The RP specimens were processed macroscopically after weight, volume and size measurements were recorded. After separating the seminal vesicles from the specimen, 2 mm-thick slices were taken from the apex and bladder neck for the SMs of the apex and bladder neck. The remaining prostate tissue was sliced at ​​4-5 mm thickness, starting from the apex. All the slices were mapped as right and left and anterior and posterior, and each quadrant was processed with a separate block. Then, all the seminal vesicles separated into right and left were processed with cross-sections. Routine hematoxylin-eosin stained sections with a thickness of 4 micrometers were examined under a microscope after 12 hours of routine tissue processing.
In addition to the SMs of the apex and bladder neck, the anterior, anterolateral, posterior and posterolateral SMs were evaluated, and the tumor quadrants were marked and mapped. All the tumor-containing blocks were examined and graded according to the 2016 ISUP consensus (2). The prognostic parameters of tumors included in radical prostatectomy reports were as follows: perineural invasion, lymphovascular invasion, SVI, EPE, tertiary pattern if present, ratio of secondary pattern to tumor, diameters of predominant tumors, ratio of tumor tissue to the whole prostate, presence/absence of prostate incision, presence/absence of prostate incision, and involvement of lymph nodes, if any. In addition, the presence of intraductal involvement in tumors was investigated and reported. Mostly, the diagnosis of acinar type adenocarcinoma and the presence and rate of ductal differentiation were also noted.