Transperineal template-guided mapping biopsy as a staging procedure to select patients best suited for active surveillance
| Autor: | Al V. Taira, Abbey Bennett, Edward Adamovich, Gregory S. Merrick, Robert W. Galbreath, Hugo Andreini, Wayne M. Butler, Walter Taubenslag, Nathan Bittner |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Extent of disease Prostate cancer Prostate Staging procedure Biopsy medicine Humans In patient Aged Neoplasm Staging Ultrasonography Aged 80 and over medicine.diagnostic_test business.industry Prostatic Neoplasms Middle Aged Prostate-Specific Antigen medicine.disease Prostate-specific antigen medicine.anatomical_structure Oncology Neoplasm staging Radiology Neoplasm Grading business |
| Zdroj: | American journal of clinical oncology. 36(2) |
| ISSN: | 1537-453X |
| Popis: | Patients with clinically insignificant prostate cancer are candidates for active surveillance. However, uncertainty regarding the true extent of disease limits enthusiasm. In this study, we report our initial findings in patients with transrectal ultrasound (TRUS)-detected clinically insignificant prostate cancer undergoing transperineal template-guided mapping biopsy (TTMB) as a staging procedure.Sixty-four patients who met the Epstein criteria for clinically insignificant prostate cancer underwent TTMB. Each biopsy core position was recorded in 3 dimensions with documentation of location of each positive biopsy core, Gleason score, percentage of involvement of each core, and presence/absence of perineural invasion.Mean pre-TRUS prostate specific antigen was 4.7 ng/mL with a Gleason score of 6 involving a median of 5% of 1 TRUS core. The mean number of TTMB biopsy cores was 58.5, with 6.6 cores positive for malignancy. Ten patients had clinically insignificant prostate cancer (15.7%), 8 had no TTMB-detected cancer (12.5%), and 46 (71.9%) had clinically significant cancer. Of patients with cancer, 37 (66.1%) had bilobar involvement and 25 (44.6%) harbored a Gleason score of ≥7. In a multivariate analysis, tobacco consumption was found to be most closely related to clinically significant disease on TTMB.TRUS biopsy underestimates disease extent and Gleason score in some patients. TTMB provides a more accurate assessment of the presence of aggressive histology. |
| Databáze: | OpenAIRE |
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