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.