Prueba de hipótesis específicas

The morphologic effects of ADT do not alllow gra- ding PC after ADT, as already explained. Although effects of finasteride and dutasteride are not so pronounced as complete ADT, they can potentially be misleading. Since conflicting results have also been yielded concerning grading prostatic cancer after external beam RT (no difference vs significant increase in Gleason score), it is believed that the Gleason grading after RT is also potentially mis- leading, especially because of the risk of overesti- mating, therefore it is not reccomended unless spe- cially requested.

At the Institute of Pathology in Ljubljana, it is our policy to always comment, even when there are no obvious signs of treatment related changes (after ADT and/or RT), that the grading after specific treat- ment can be misleading and should be interpreted with caution.

Conclusion

In conclusion, clinical information on previous pros- tate specific treatment is necessary for reliable diag- nostisc of prostate pathology. This is especially true in needle biopsies of prostate cancer patients, since different treatment methods produce similar tissue changes, affecting benign glands, PIN and PC. Gleason grading in treated PC is unreliable and there- fore not recommended.

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