Influence of the Prostate Volume, Prostate Specific Antigen Density and Number of Biopsy Samples on Prostate Cancer Detection

Background: Patients with high prostate volume (>80 ml) and high PSA levels make it difficult to decide on prostate biopsy. In this study, author aimed to detect of predictive factors to distinguish malignant or benign prostatic lesions in patients with prostate size over 80 ml.Methods: A total of 299 patients underwent TRUSBP at the clinics between 2012-2017. Cases with prostate volume over 80 ml were divided into groups according to the pathology by benign (group 1) or malign (group 2). Author evaluated the predictive factors in two groups. Patient’s age, grading and findings of digital rectal examination, prostate volume, number of received cores, total (tPSA) and free PSA (fPSA) before biopsy, rate of percentage of free to total prostate specific antigen (f/tPSA) and PSA density was compared in both groups.Results: Benign prostate hyperplasia was detected in 217 patients (72.58%) and prostate adenocarcinoma was detected in 82 patients (27.42%). The patient’s age, tPSA, fPSA and PSA density were 63.81 years, 9.71 ng/ml, 1.78 ng/ml and 0.10 g/ml2 in group 1 and 69.10 years, 38.32 ng/ml, 5.86 ng/ml and 0.42 ng/ml2 respectively. Patient’s age, tPSA, fPSA and PSA density was statistically significant between in two groups (p<0,05). Number of received cores and rate of f/tPSA were 14.02-13.84% and 19.06-17.62% in group 1 and 2, respectively and was not statistically significant. In group 2, prostate adenocarcinoma was most common detected with Gleason score 4+3 in 21 of 82 patients (25.6%).Conclusions: High prostate volume (>80 ml) has a significant influence in PSA values and results of the biopsy, PSA density is extremely important in performing prostate biopsy decisions.

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“…Aganovic et al were found higher PSA density is related to a higher Gleason score and it supports the results. 13…”

Section: Resultsmentioning

confidence: 99%

PSA density as a parameter in prostate biopsy decision of patients with prostate sized 80 mL or larger

Ediz¹,

Çimen

Akan³

et al. 2019

Int J Res Med Sci

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“…However, it indicates that in our study a change in the number of taken cores (targeted) should not significantly affect the results obtained. There are scientific publications on the impact of the number of collected cores on the detection of prostate cancer, it has been shown that their increase correlates with the improvement in detection [ 14 , 15 , 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

The influence of the operator's experience on the outcomes of fusion prostate biopsy

2023

cent European J Urol

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Introduction Magnetic resonance imgaing (MRI) targeted biopsy is the gold standard for prostate cancer (PCa) diagnosis. In this study, we examined the association between the operator’s experience and the improvement in the precision of the MRI prostate biopsy procedure and the detection of PCa. Material and methods We included consecutive patients who underwent prostate fusion biopsy. Data on biopsy duration, prostate-specific antigen (PSA) value, lesion size, number of samples taken, number of cores involved, and International Society of Urological Pathology (ISUP) grade were subjected to statistical analysis, with the study group divided into three consecutive time periods (tertiles). Results There were statistically significant differences in biopsy duration between tertiles (p <0.001). The greatest difference in the involved/taken cores ratio occurred between the first and third tertile (p = 0.002). The difference between the first and second tertile was insignificant (p = 0.4), while the difference between the second and third tertile was statistically significant (p = 0.004). The differences between tertiles in Prostate Imaging and Reporting Data System v2.1 were also significant (p = 0.003). The PSA value (p = 0.036) was statistically significant, unlike prostate volume (p = 0.16), digital rectal examination (DRE) (p = 0.7), and ISUP grade (p = 0.7). There was no statistical difference between tested tertiles in the number of detected PCa ISUP ≥2 (Z = 0.191; p = 0.8). Conclusions The abilities and precision of the operator increase with the increase in the number of procedures performed. The biopsy duration is shortened, and the detection of PCa during the procedure seems to improve with the operator’s experience.

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“…The adequate sampling number has not yet been determined. Aganovic et al [ 20 ] reported that a higher number of biopsy samples (mean, 14.1 vs. 10.9 with initially detected cancer) was related to a higher chance of cancer detection with repeat biopsy [ 20 ]. Since the rebiopsy group showed a larger prostate volume with a lower tumor burden, targeting more than the 12-core routine biopsy might be recommendable.…”

Section: Discussionmentioning

confidence: 99%

The characteristics and spatial distributions of initially missed and rebiopsy-detected prostate cancers

You

Kim

et al. 2016

Ultrasonography

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Purpose:The purpose of this study was to analyze the characteristics of initially missed and rebiopsy-detected prostate cancers following 12-core transrectal biopsy.Methods:A total of 45 patients with prostate cancers detected on rebiopsy and 45 patients with prostate cancers initially detected on transrectal ultrasound-guided biopsy were included in the study. For result analysis, the prostate was divided into six compartments, and the cancer positive rates, estimated tumor burden, and agreement rates between biopsy and surgical specimens, along with clinical data, were evaluated.Results:The largest mean tumor burden was located in the medial apex in both groups. There were significantly more tumors in this location in the rebiopsy group (44.9%) than in the control group (30.1%, P=0.015). The overall sensitivity of biopsy was significantly lower in the rebiopsy group (22.5% vs. 43.4%, P<0.001). The agreement rate of cancer positive cores between biopsy and surgical specimens was significantly lower in the medial apex in the rebiopsy group compared with that of the control group (50.0% vs. 65.6%, P=0.035). The cancer positive rates of target biopsy cores and premalignant lesions in the rebiopsy group were 63.1% and 42.3%, respectively.Conclusion:Rebiopsy-detected prostate cancers showed different spatial distribution and lower cancer detection rate of biopsy cores compared with initially diagnosed cancers. To overcome lower cancer detection rate, target biopsy of abnormal sonographic findings, premalignant lesions and medial apex which revealed larger tumor burden would be recommended when performing rebiopsy.

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Influence of the Prostate Volume, Prostate Specific Antigen Density and Number of Biopsy Samples on Prostate Cancer Detection

Cited by 7 publications

References 16 publications

PSA density as a parameter in prostate biopsy decision of patients with prostate sized 80 mL or larger

PSA density as a parameter in prostate biopsy decision of patients with prostate sized 80 mL or larger

The influence of the operator's experience on the outcomes of fusion prostate biopsy

The characteristics and spatial distributions of initially missed and rebiopsy-detected prostate cancers

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