The Value of an Extensive Transrectal Repeat Biopsy with Anterior Sampling in Men on Active Surveillance for Low-risk Prostate Cancer: A Comparison from the Randomised Study of Active Monitoring in Sweden (SAMS)
| Autor: | Linda Drevin, Jonas Sandberg, Pär Stattin, David Robinsson, Stefan Carlsson, Andreas Josefsson, Ola Bratt, Erik Holmberg, Eva Johansson, Ove Andrén, Maria Nyberg |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Urology 030232 urology & nephrology Risk Assessment 03 medical and health sciences Prostate cancer 0302 clinical medicine Biopsy Medicine Humans Sampling (medicine) Prospective Studies Watchful Waiting Aged Sweden medicine.diagnostic_test Repeat biopsy business.industry Active monitoring Prostate Rectum Prostatic Neoplasms Middle Aged medicine.disease 030220 oncology & carcinogenesis Radiology Biopsy Large-Core Needle Neoplasm Grading business |
| Zdroj: | European urology. 76(4) |
| ISSN: | 1873-7560 |
| Popis: | A systematic repeat biopsy is recommended for men starting on active surveillance for prostate cancer, but the optimal number and distribution of cores are unknown.To evaluate an extensive repeat transrectal biopsy with anterior sampling in men starting on active surveillance.Randomised multicentre trial. From 2012 to 2016, 340 Swedish men, aged 40-75yr, with recently diagnosed low-volume Gleason grade group 1 prostate cancer were included.Either an extensive transrectal biopsy with anterior sampling (median 19 cores) or a standard transrectal biopsy (median 12 cores).Primary outcome measure: Gleason grade group ≥2 cancer.Cancer in anteriorly directed biopsy cores and postbiopsy infection. Nonparametric statistical tests were applied.Gleason grade group ≥2 cancer was detected in 16% of 156 men who had an extensive biopsy and in 10% of 164 men who had a standard biopsy, a 5.7% difference (95% confidence interval [CI]-0.2% to 13%, p=0.09). There was a strong linear association between prostate-specific antigen (PSA) density and cancer in the anteriorly directed biopsy cores. The odds ratios for cancer in the anteriorly directed cores were for any cancer 2.2 (95% CI 1.3-3.9, p=0.004) and for Gleason grade group ≥2 cancer 2.3 (95% CI 1.2-4.4, p=0.015) per 0.1-ng/ml/cmThe trial did not support general use of the extensive transrectal repeat biopsy template, but cancer in the anteriorly directed cores was common, particularly in men with high PSA density. The higher the PSA density, the stronger the reason to include anterior sampling at a systematic repeat biopsy.This trial compared two different templates for transrectal prostate biopsy in men starting on active surveillance for low-risk prostate cancer. Cancer was often found in the front part of the prostate, which is not sampled on a standard prostate biopsy. |
| Databáze: | OpenAIRE |
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