1. Impact on histo-pathological reporting with different specimen collection protocols for TRUS biopsy of the prostate. F Harris, C Fragkopoulou, V Dabbagh, G M Nandwani, S K Addla.

2. Specimen Collection Techniques Protocol 1 – All specimens from one side sent in a single pot – The technician in pathology lab individually separates them and fixes them on sponges Protocol 2 – Specimen fixed into individual cassettes and sent to pathology lab

3. Aim & Methods To assess the histo-pathological concordance of number of cores with – Protocol 1 – Protocol 2 Parameters assessed – Cancer diagnosis – Core length – Concordance in number of cores sent and reported

4. Results Protocol 1 – Feb 2010 – May 2010 – Patients61 – Specimen pots138 Protocol 2 – Apr 2011 – Aug 2011 – Patients74 – Specimen pots163

5. Results Mean PSA = 13.96 Mean age = 65 years

6. Results Protocol 1Protocol 2 Total No. of patients6174 Ca Positive26 (42.6%)37 (50.0%) Core length (mm)Protocol 1 Protocol 2 Range 1-25 6 - 20 Mean 14.9 14.15 Median 15

7. Results – Number of cores sent & reported Protocol 1 Protocol 2 Total Number of Patients 61 74 Discrepancy 42 (68.8%) 23 (31.1%) ( P = 0.01) Concordance 19 (31.2%) 51 (68.9) Total Number of Specimens 138 163 Discrepancy 60 (43.5%) 31 (19%) ( P = 0.001) Concordance 78 (56.5%) 132 (81%)

8. Biopsy number-concordance DiscrepancyProtocol 1 Protocol 2 Range1-4 Mean1.6 1.48 Median1 1 DiscrepancyProtocol 1Protocol 2 Negative4019 Positive2012

9. Conclusion Overall 50% of patients diagnosed with prostate cancer in Protocol 2 compared to Protocol 1 (42.6%) Improvement in concordance in Protocol 2 from 56.5% to 81.0% Protocol 2 now standard