International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 1: specimen handling

The 2009 International Society of Urological Pathology Consensus Conference in Boston made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to the handling and processing of radical prostatectomy specimens were coordinated by working group 1. Most uropathologists followed similar procedures for fixation of radical prostatectomy specimens, with 51% of respondents transporting tissue in formalin. There was also consensus that the prostate weight without the seminal vesicles should be recorded. There was consensus that the surface of the prostate should be painted. It was agreed that both the prostate apex and base should be examined by the cone method with sagittal sectioning of the tissue sample. There was consensus that the gland should be fully fixed before sectioning. Both partial and complete embedding of prostates was considered to be acceptable as long as the method of partial embedding is stated. No consensus was determined regarding the necessity of weighing and measuring the length of the seminal vesicles, the preparation of whole mounts rather than standardized blocks and the methodology for sampling of fresh tissue for research purposes, and it was agreed that these should be left to the discretion of the working pathologist.

[1]  Christopher K. Poulos,et al.  Bladder neck invasion is an independent predictor of prostate‐specific antigen recurrence , 2004, Cancer.

[2]  S. Diaz-Cano,et al.  DNA Extraction from Formalin‐fixed, Paraffin‐embedded Tissues: Protein Digestion as a Limiting Step for Retrieval of High‐quality DNA , 1997, Diagnostic molecular pathology : the American journal of surgical pathology, part B.

[3]  F. Montorsi,et al.  Stage pT0 in radical prostatectomy with no residual carcinoma and with a previous positive biopsy conveys a wrong message to clinicians and patients: why is cancer not present in the radical prostatectomy specimen? , 2009, European urology.

[4]  A. Renshaw,et al.  Protocol for the examination of specimens from patients with carcinoma of the prostate gland. , 2009, Archives of pathology & laboratory medicine.

[5]  U. Vaishampayan,et al.  Adjuvant Chemo-/Hormonal Therapy Trials for Locally Advanced Prostate Cancer , 2000, Current oncology reports.

[6]  Sten Nilsson,et al.  Prognostic factors and reporting of prostate carcinoma in radical prostatectomy and pelvic lymphadenectomy specimens , 2005, Scandinavian journal of urology and nephrology. Supplementum.

[7]  P. Nelson,et al.  Molecular Alterations in Prostate Carcinomas that Associate with In vivo Exposure to Chemotherapy: Identification of a Cytoprotective Mechanism Involving Growth Differentiation Factor 15 , 2007, Clinical Cancer Research.

[8]  G. Miller,et al.  Rapid microwave‐stimulated fixation of entire prostatectomy specimens , 1997, The Journal of pathology.

[9]  Ronglai Shen,et al.  Changes in differential gene expression because of warm ischemia time of radical prostatectomy specimens. , 2002, The American journal of pathology.

[10]  S. Jewell,et al.  Copyright © American Society for Investigative Pathology Review Effect of Fixatives and Tissue Processing on the Content and Integrity of Nucleic Acids , 2022 .

[11]  R. Montironi,et al.  Search for residual prostate cancer on pT0 radical prostatectomy after positive biopsy , 2007, Virchows Archiv.

[12]  J. Köllermann,et al.  Nondetected Tumor (pT0) after Prolonged, Neoadjuvant Treatment of Localized Prostatic Carcinoma , 2000, European Urology.

[13]  F. Montorsi,et al.  Critical evaluation of the prostate from cystoprostatectomies for bladder cancer: insights from a complete sampling with the whole mount technique. , 2009, European urology.

[14]  P. Chu,et al.  Assessment of low prostate weight as a determinant of a higher positive margin rate after laparoscopic radical prostatectomy: a prospective pathologic study of 1,500 cases , 2009, Surgical Endoscopy.

[15]  M. Cohen,et al.  Sampling of radical prostatectomy specimens. How much is adequate? , 1994, American journal of clinical pathology.

[16]  S. Best,et al.  Integrity of prostatic tissue for molecular analysis after robotic-assisted laparoscopic and open prostatectomy. , 2007, Urology.

[17]  F. Hamdy,et al.  Secular trends in prostate cancer mortality, incidence and treatment: England and Wales, 1975–2004 , 2008, BJU international.

[18]  S. Cross,et al.  Reassessment of the rate of fixative diffusion. , 1992, Journal of clinical pathology.

[19]  B. Delahunt,et al.  International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 4: seminal vesicles and lymph nodes , 2011, Modern Pathology.

[20]  D. Grignon,et al.  Prostate. Practice parameters, pathologic staging, and handling radical prostatectomy specimens. , 1999, The Urologic clinics of North America.

[21]  R. Rees,et al.  Obtaining fresh prostate cancer tissue for research: A novel biopsy needle and sampling technique for radical prostatectomy specimens , 2005, The Prostate.

[22]  H. Puchtler,et al.  On the chemistry of formaldehyde fixation and its effects on immunohistochemical reactions , 2004, Histochemistry.

[23]  Leroy Hood,et al.  A molecular correlate to the Gleason grading system for prostate adenocarcinoma. , 2006, Proceedings of the National Academy of Sciences of the United States of America.

[24]  Morphological assessment of radical prostatectomy specimens. A protocol with clinical relevance , 2003, Virchows Archiv.

[25]  J. Epstein,et al.  Detection of Cancer in Radical Prostatectomy Specimens With no Residual Carcinoma in the Initial Review of Slides , 2009, The American journal of surgical pathology.

[26]  D. Bostwick,et al.  Evaluating radical prostatectomy specimens: Therapeutic and prognostic importance , 2005, Virchows Archiv.

[27]  J. Srigley.  Key issues in handling and reporting radical prostatectomy specimens. , 2009, Archives of pathology & laboratory medicine.

[28]  R. Mazzucchelli,et al.  Finding of no tumor (pT0) in patients undergoing radical retropubic prostatectomy for clinically localized prostate cancer. , 2007, Analytical and quantitative cytology and histology.

[29]  J. Epstein,et al.  Positive Surgical Margins in Areas of Capsular Incision in Otherwise Organ-confined Disease at Radical Prostatectomy: Histologic Features and Pitfalls , 2008, The American journal of surgical pathology.

[30]  J. Epstein,et al.  Characterization of minute adenocarcinomas of prostate at radical prostatectomy. , 2004, Urology.

[31]  K. Trpkov,et al.  No residual cancer on radical prostatectomy after positive 10-core biopsy: incidence, biopsy findings, and DNA specimen identity analysis. , 2009, Archives of pathology & laboratory medicine.

[32]  J. Epstein,et al.  Little or No Residual Prostate Cancer at Radical Prostatectomy: Vanishing Cancer or Switched Specimen?: A Microsatellite Analysis of Specimen Identity , 2005, The American journal of surgical pathology.

[33]  D. Cherwitz.  A Handbook of Surgical Pathology , 1879, Edinburgh Medical Journal.

[34]  M. Rubin,et al.  Whole mounted radical prostatectomy specimens do not increase detection of adverse pathological features. , 2000, The Journal of urology.

[35]  S. Herrell,et al.  A comparison of the incidence and location of positive surgical margins in robotic assisted laparoscopic radical prostatectomy and open retropubic radical prostatectomy. , 2007, The Journal of urology.

[36]  J. Epstein,et al.  Do close but negative margins in radical prostatectomy specimens increase the risk of postoperative progression? , 1997, The Journal of urology.

[37]  M. Peyromaure,et al.  Can pT0 stage of prostate cancer be predicted before radical prostatectomy? , 2006, European urology.

[38]  L. Kiemeney,et al.  The prognostic role of the pathological T2 subclassification for prostate cancer in the 2002 Tumour‐Nodes‐Metastasis staging system , 2008, BJU international.

[39]  A. Osunkoya,et al.  Evaluation of modern pathological criteria for positive margins in radical prostatectomy specimens and their use for predicting biochemical recurrence , 2009, BJU international.

[40]  Liang Cheng,et al.  International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 5: surgical margins , 2011, Modern Pathology.

[41]  C. Pan,et al.  Comparative analysis of sampling methods for grossing radical prostatectomy specimens performed for nonpalpable (stage T1c) prostatic adenocarcinoma. , 2001, Human pathology.

[42]  Michael W Kattan,et al.  Postoperative nomogram predicting the 10-year probability of prostate cancer recurrence after radical prostatectomy. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[43]  M. Varma,et al.  Effect of formalin fixation and epitope retrieval techniques on antibody 34betaE12 immunostaining of prostatic tissues. , 1999, Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc.

[44]  Liang Cheng,et al.  Closest Distance Between Tumor and Resection Margin in Radical Prostatectomy Specimens: Lack of Prognostic Significance , 2005, The American journal of surgical pathology.

[45]  International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 2: T2 substaging and prostate cancer volume , 2010 .

[46]  M. Kattan,et al.  Postoperative nomogram for disease recurrence after radical prostatectomy for prostate cancer. , 1999, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[47]  Lars Egevad,et al.  International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens: rationale and organization , 2011, Modern Pathology.

[48]  M. Rubin,et al.  Inadequate formalin fixation decreases reliability of p27 immunohistochemical staining: probing optimal fixation time using high-density tissue microarrays. , 2002, Human pathology.

[49]  Magnus Hellström,et al.  Evaluation of two sample preparation methods for prostate proteome analysis , 2006, Proteomics.

[50]  J. Epstein,et al.  Increasing incidence of minimal residual cancer in radical prostatectomy specimens. , 1997, The American journal of surgical pathology.

[51]  Magnus Hellström,et al.  Tissue shrinkage after fixation with formalin injection of prostatectomy specimens , 2006, Virchows Archiv.

[52]  W. Isaacs,et al.  The Prostate 69 : 214 ^ 218 ( 2009 ) Genome-Wide ExpressionAnalysis of Recently ProcessedFormalin-FixedParaffinEmbeddedHuman ProstateTissues , 2008 .

[53]  J. Epstein,et al.  Evaluation of Radical Prostatectomy Specimens: A Comparative Analysis of Sampling Methods , 1992, The American journal of surgical pathology.

[54]  Rodolfo Montironi,et al.  International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 3: extraprostatic extension, lymphovascular invasion and locally advanced disease , 2011, Modern Pathology.

[55]  C. Busch,et al.  Histopathology of localized prostate cancer. Consensus Conference on Diagnosis and Prognostic Parameters in Localized Prostate Cancer. Stockholm, Sweden, May 12-13, 1993. , 1994, Scandinavian journal of urology and nephrology. Supplementum.

[56]  A. Leong,et al.  The Effects of Progressive Formaldehyde Fixation on the Preservation of Tissue Antigens , 1989, Pathology.