Pathological Evaluation
A uropathologist with 15 years of experience analysed all RP specimens.
Based on the prostate’s regional anatomy, specimens were examined in
3-mm sections in cassettes, starting from the bladder neck and moving
towards the prostatic apex, after sampling the apex and bladder neck
surgical margins and staining the surgical margins of the prostate.
Slices were placed on A4 papers for tumour mapping, and their borders
were drawn in pencil. After determining the right, left, anterior and
posterior orientation, it was marked counterclockwise starting from 1.
Since whole-mount sectioning could not be made, all transverse sections
were divided into four pieces to fit the tissue cassettes, taking into
account anterior/posterior and right/left discrimination based on the
urethra. Hematoxylin-eosin stained sections were prepared after paraffin
tissue processing. After tissue sections were examined microscopically,
mapping was performed by drawing around the tumour areas on slides. The
marked slides were placed on A4 paper according to their locations in
the drawn prostate slices during the macroscopic sampling. The tumoural
areas identified in the slides were transferred onto A4 paper, and the
tumour mapping was completed. Tumour grade groups were reported
according to the ISUP 2014 consensus conference[8]. Tumour grade
group, tumour diameter, approximate tumour volume, extraprostatic
extension, surgical margin and local infiltration status (seminal
vesicle and bladder neck), and tumour grade and linear length at the
surgical margin, if any, were reported for each tumour. The highest ISUP
grade group was determined as the criterion for index lesion selection.
The extraprostatic extension was determined as a secondary criterion if
there were more than one lesion with the same ISUP grade group. If there
were no extraprostatic extensions, the lesion with the largest diameter
was determined as the index lesion.