Evaluation of the effects of prostate adenocarcinoma on prognosis in radical prostatectomy materials with recent updates

Aim: In the last 10 years, important updates have been made on the classification and grading of prostate adenocarcinoma at radical prostatectomy materials, as a result of decisions in international conferences and effective publications. These changes are closely related to the prognosis of the patient. With this study, it is aimed to compare the incidence of these changes and their effects on patient prognosis, and to divide patients into clinically significant groups for multidisciplinary treatment planning. Materials and Methods: Cases diagnosed between 2010 and 2021 and who underwent radical prostatectomy at Manisa CBU Faculty of Medicine were evaluated. A total of 182 prostate adenocarcinoma cases whose hematoxylin eosin stained sections and, if any, immunohistochemical stained sections could be accessed from the archive, were included in the study. The relationship between the histopathological data and clinical data was investigated. Results: The poor prognostic effects of grade group, lymphovascular invasion, intraductal carcinoma, positive surgical margins, extraprostatic extension, pathological T stage and seminal vesicle invasion which are important determinants of recurrence-free survival in prostate adenocarcinomas, were proven in our study. Conclusions: In this study, most of our findings on the histopathological parameters suggested to best predict the prognosis in prostate adenocarcinomas were consistent with the literature, but the effect of cribriformity, Gleason score/patern on positive surgical margins and comedo necrosis on the prognosis could not be demonstrated. Since there are publications that reach different results on these issues, there is a need for new studies with large and multivariate analyzes in patient groups with long follow-up. Keywords: Prostate adenocarcinoma, comedo necrosis, positive surgical margins, biochemical recurrence