Assessment of histopathological features of needle biopsy in recurrent prostate cancer following salvage high-intensity focused ultrasound

Michele Billia, Khurram M. Siddiqui, Susanne Chan, Fan Li, Ali Al-Zahrani, Jose A. Gomez, Joseph L. Chin

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: Local recurrence of prostate cancer (PCa) following radiotherapy may be treated with curative intent using salvage highintensity focused ultrasound (s-HIFU). The interpretation of needle core biopsy specimens following s-HIFU is a daunting task, even for experienced pathologists. We describe various histopathological features encountered in biopsy specimens following whole-gland s-HIFU in one of the largest descriptive studies to date. Methods: Fifty-five patients with biopsy-proven localized radiorecurrent PCa underwent s-HIFU and transrectal ultrasound (TRUS)- guided prostatic needle biopsies at 180 days post-treatment. All biopsies were reviewed by two genitourinary pathologists. Results: PCa was detected in 11 (24%) biopsies. Radiation therapyassociated changes were identified in all cases. Additional findings included extensive coagulative stromal necrosis (100%), smudgy chromatin of cancer nuclei (82%), and markedly enlarged bizarre nuclei in the residual cancer (55%). Gleason grade assignment was possible in 10 (91%) of these biopsies and concordance of Gleason grading between pre- and post-therapy specimens was observed in six (60%) cases. Conclusions: The histological interpretation of needle biopsies following salvage HIFU is challenging and requires an understanding of the histopathological changes associated with this procedure in both tumoural and non-tumoural prostatic tissue. Accurate interpretation of the morphological changes following s-HIFU is instrumental for optimization of clinical decision-making and treatment planning in recurrent PCa.

Original languageEnglish
Pages (from-to)416-422
Number of pages7
JournalJournal of the Canadian Urological Association
Volume10
Issue number11-12
DOIs
Publication statusPublished - Dec 1 2016

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Needle Biopsy
Prostatic Neoplasms
Biopsy
Large-Core Needle Biopsy
Neoplasm Grading
Residual Neoplasm
Therapeutics
Chromatin
Necrosis
Radiotherapy
Radiation
Recurrence
Neoplasms
Pathologists

ASJC Scopus subject areas

  • Oncology
  • Urology

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Assessment of histopathological features of needle biopsy in recurrent prostate cancer following salvage high-intensity focused ultrasound. / Billia, Michele; Siddiqui, Khurram M.; Chan, Susanne; Li, Fan; Al-Zahrani, Ali; Gomez, Jose A.; Chin, Joseph L.

In: Journal of the Canadian Urological Association, Vol. 10, No. 11-12, 01.12.2016, p. 416-422.

Research output: Contribution to journalArticle

Billia, Michele ; Siddiqui, Khurram M. ; Chan, Susanne ; Li, Fan ; Al-Zahrani, Ali ; Gomez, Jose A. ; Chin, Joseph L. / Assessment of histopathological features of needle biopsy in recurrent prostate cancer following salvage high-intensity focused ultrasound. In: Journal of the Canadian Urological Association. 2016 ; Vol. 10, No. 11-12. pp. 416-422.
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abstract = "Introduction: Local recurrence of prostate cancer (PCa) following radiotherapy may be treated with curative intent using salvage highintensity focused ultrasound (s-HIFU). The interpretation of needle core biopsy specimens following s-HIFU is a daunting task, even for experienced pathologists. We describe various histopathological features encountered in biopsy specimens following whole-gland s-HIFU in one of the largest descriptive studies to date. Methods: Fifty-five patients with biopsy-proven localized radiorecurrent PCa underwent s-HIFU and transrectal ultrasound (TRUS)- guided prostatic needle biopsies at 180 days post-treatment. All biopsies were reviewed by two genitourinary pathologists. Results: PCa was detected in 11 (24{\%}) biopsies. Radiation therapyassociated changes were identified in all cases. Additional findings included extensive coagulative stromal necrosis (100{\%}), smudgy chromatin of cancer nuclei (82{\%}), and markedly enlarged bizarre nuclei in the residual cancer (55{\%}). Gleason grade assignment was possible in 10 (91{\%}) of these biopsies and concordance of Gleason grading between pre- and post-therapy specimens was observed in six (60{\%}) cases. Conclusions: The histological interpretation of needle biopsies following salvage HIFU is challenging and requires an understanding of the histopathological changes associated with this procedure in both tumoural and non-tumoural prostatic tissue. Accurate interpretation of the morphological changes following s-HIFU is instrumental for optimization of clinical decision-making and treatment planning in recurrent PCa.",
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N2 - Introduction: Local recurrence of prostate cancer (PCa) following radiotherapy may be treated with curative intent using salvage highintensity focused ultrasound (s-HIFU). The interpretation of needle core biopsy specimens following s-HIFU is a daunting task, even for experienced pathologists. We describe various histopathological features encountered in biopsy specimens following whole-gland s-HIFU in one of the largest descriptive studies to date. Methods: Fifty-five patients with biopsy-proven localized radiorecurrent PCa underwent s-HIFU and transrectal ultrasound (TRUS)- guided prostatic needle biopsies at 180 days post-treatment. All biopsies were reviewed by two genitourinary pathologists. Results: PCa was detected in 11 (24%) biopsies. Radiation therapyassociated changes were identified in all cases. Additional findings included extensive coagulative stromal necrosis (100%), smudgy chromatin of cancer nuclei (82%), and markedly enlarged bizarre nuclei in the residual cancer (55%). Gleason grade assignment was possible in 10 (91%) of these biopsies and concordance of Gleason grading between pre- and post-therapy specimens was observed in six (60%) cases. Conclusions: The histological interpretation of needle biopsies following salvage HIFU is challenging and requires an understanding of the histopathological changes associated with this procedure in both tumoural and non-tumoural prostatic tissue. Accurate interpretation of the morphological changes following s-HIFU is instrumental for optimization of clinical decision-making and treatment planning in recurrent PCa.

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