The handling and sampling of radical prostatectomy specimens for reporting and research: the Oxford approach
- Pelvender Singh Gill1,
- Ian S D Roberts2,
- Lisa Browning1,
- Ranmith Perera2,
- Anne Y Warren3,
- Freddie C Hamdy4,
- Clare Verrill1
- 1Department of Cellular Pathology and Oxford Biomedical Research Centre, Oxford University Hospitals NHS Trust, Oxford, UK.
- 2Department of Cellular Pathology, Oxford University Hospitals NHS Trust, Oxford, UK.
- 3Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
- 4Nuffield Department of Surgical Sciences, University of Oxford, UK.
- Correspondence to Dr Clare Verrill, Department of Cellular Pathology, Oxford University Hospitals NHS Trust, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK;
- Accepted 26 June 2012
- Published Online First 7 August 2012
This article reviews previously described methods of fresh tissue sampling from radical prostatectomy specimens for research and describes a method used in Oxford which is simple, logical and cost effective. The method utilises a systematic zonal approach to tissue procurement in order to meet the increasing requirement for research samples with detailed morphological information such as zone of origin, tumour stage and Gleason grade.
The described method involves punch biopsy sampling from a 4mm thick transverse slice cut 8mm superior to the apex. 9 biopsies are taken from each specimen in the following zonal distribution: Mid anterior, right lateral, right peripheral zone lateral, right peripheral zone mid, left peripheral zone mid, left peripheral zone lateral, left lateral, left transition zone and right transition zone.
The method was validated by successfully sampling tumour in 7 out of 8 cases (88%). In 6 of the positive cases, tumour was present in more than 1 punch biopsy. The mean time from receipt of the specimen to completion of the biopsy freezing was 23.5 minutes. Tumour stage, zone and Gleason grade were determined for all positive biopsies. All cases were reported to RCPath guidelines with no compromising of margins.
A logical systematic method of fresh tissue sampling from radical prostatectomy specimens is presented, which balances the need for accurate routine histopathological reporting with the requirement for increasingly complex research samples to be taken with attention to morphological details such as zone and stage.