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Contemporary prostate biopsy reporting: insights from a survey of clinicians’ use of pathology data
  1. Murali Varma1,
  2. Krishna Narahari2,
  3. Malcolm Mason3,
  4. Jon D Oxley4,
  5. Daniel M Berney5
  1. 1 Department of Pathology, University Hospital of Wales, Cardiff, UK
  2. 2 Department of Urology, University Hospital of Wales, Cardiff, UK
  3. 3 Department of Oncology, Cardiff University, Cardiff, UK
  4. 4 Department of Pathology, Southmead Hospital, Bristol, UK
  5. 5 Department of Molecular Oncology, Queen Mary University of London, London, UK
  1. Correspondence to Dr Murali Varma, Department of Cellular Pathology, University Hospital of Wales, Cardiff CF14 4XN, UK; wptmv{at}


Aim To determine how clinicians use data in contemporary prostate biopsy reports.

Methods A survey was circulated to members of the British Association of Urological Surgeons and the British Uro-oncology Group.

Results Responses were received from 114 respondents (88 urologists, 26 oncologists). Ninety-seven (94%) use the number of positive cores from each side and 43 (42%) use the % number of positive cores. When determining the number and percentage of positive cores, 72 (71%) would not differentiate between targeted and non-targeted samples. If multiple Gleason Scores (GS) were included in a report, 77 (78%) would use the worst GS even if present in a core with very little tumour, 12% would use the global GS and 10% the GS in the core most involved by tumour. Fifty-five (55%) either never or rarely used perineural invasion for patient management.

Conclusions The number of positive cores is an important parameter for patient management but may be difficult to determine in the laboratory due to core fragmentation so the biopsy taker must indicate the number of biopsies obtained. Multiple biopsies taken from a single site are often interpreted by clinicians as separate cores when determining the number of positive cores so pathologists should also report the number of sites positive. Clinicians have a non-uniform approach to the interpretation of multiple GS in prostate biopsy reports so we recommend that pathologists also include a single ‘bottom-line’ GS for each case to direct the clinician’s treatment decision.

  • prostate
  • genitourinary pathology
  • urogenital pathology

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  • Handling editor Runjan Chetty.

  • Contributors All authors contributed equally to the study.

  • Funding DMB is supported by The Orchid Appeal.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.