Review of the Pattern of Prostate Cancer Aggressiveness Using the Gleason Scoring System among Men Attending Abia State University Teaching Hospital Aba, South Eastern, Nigeria

Abstract

Prostate cancer is the most common cancer among African – American men and the second most common cause of death in the western world.

It is the most common cancer among Nigerian men with increasing incidence, morbidity and mortality. The morbidity and mortality depend on the tumor aggressiveness.

The three most important prognostic parameters for this disease include

• Tumor pathologic stage
• Tumor histologic differentiation (gleason score)
• Level of prostate specific antigen (PSA)

These factors are needed in stratifying patients into risk groups. The gleason grading system , both in needle biopsy and radical prostatectomy specimens remains one of the most significant factors in the clinical decision making process.

Key Challenges of the biopsy based determination of prostate cancer aggressiveness include

• Tumor heterogeneity
• Biopsy sampling error and variations in biopsy interpretations

The resulting uncertainty in risk assessment leads to significant over treatment with associated cost and morbidity.