Performance of transrectal prostate biopsies in detecting tumours and implications for focal therapy

Lahdensuo, Kanerva; Mirtti, Tuomas; Pétas, Anssi; Rannikko, Antti

doi:10.3109/21681805.2014.936494

Cited by 6 publications

(4 citation statements)

References 30 publications

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“…Cohorts with an adequate number of patients and sufficient follow-up time for PCSM are rarely available. In addition, pre-magnetic resonance imaging (MRI)-era transrectal ultrasound-guided (TRUS) biopsies are prone to significant sampling error, thus higher grade prostate cancer foci are missed in up to 30% of GS 3 + 3 biopsies [24,25]. Validation of the GG system in predicting the all-cause mortality (ACM) and PCSM compared to conventional Gleason grade pattern scores is essential in order to facilitate its use in patient communication.…”

Section: Introductionmentioning

confidence: 99%

New prostate cancer grade grouping system predicts survival after radical prostatectomy

et al. 2018

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Histological Gleason grading of prostate cancer has been through modifications and conjoined into a Grade Grouping system recently. The aim of this study was to determine whether the new Grade Grouping system predicts disease-specific and all-cause mortality after radical prostatectomy. We constructed a clinical database consisting of all consecutively radical prostatectomy-treated men between 1983 and 1998 and between 2000 and 2005 at the Helsinki University Hospital and at the Turku University Hospital, respectively. Patients' all-cause and prostate cancer-specific mortality information was updated in November 2015 from the Finnish Cancer Registry. Secondary therapy information was also available from the patients' records at Helsinki. Univariate and multivariate statistical analyses were performed to assess predictive significance of the Grade Grouping system. Grade Grouping associated independently with increased risk of prostate cancer-specific mortality within 15 years of follow-up in a multivariable model containing age at operation, diagnostic prostate-specific antigen, pathological stage and lymph node status at operation. Additionally, the all-cause mortality-free survival time and time to secondary therapies were different between the Grade Groups, emphasized in the subanalysis of Grade Groups 1-2 versus Grade Groups 3-5. We can conclude that the new Grade Grouping system is feasible in predicting prostate cancer-specific survival after radical surgical treatment. Grade Grouping offers a simpler way to interpret the predicted course of the disease to individual patients and thus may help in justifying more conservative follow-up approaches, especially in the lower Grade Group patients.

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Section: Introductionmentioning

confidence: 99%

New prostate cancer grade grouping system predicts survival after radical prostatectomy

et al. 2018

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“…Histological findings of Bx remain the main prognostic factor for PCa. However, random Bx may repeatedly miss significant cancers of the prostate, which contributes to undergrading of the PCa present in the patient [ 4 ]. AS cohort studies with radical prostatectomy (RP) or confirmatory Bx samples show an upgrading from diagnostic Bx for 20 to 30 percent of the cases [ 3 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Repeat multiparametric MRI in prostate cancer patients on active surveillance

et al. 2017

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IntroductionThis study was conducted to describe the changes in repeat multiparametric MRI (mpMRI) occurring in prostate cancer (PCa) patients during active surveillance (AS), and to study possible associations between mpMRI-related parameters in predicting prostate biopsy (Bx) Gleason score (GS) upgrading >3+3 and protocol-based treatment change (TC).Materials and methodsThe study cohort consisted of 76 AS patients with GS 3+3 PCa and at least two consecutive mpMRIs of the prostate performed between 2006–2015. Patients were followed according to the Prostate Cancer Research International Active Surveillance (PRIAS) protocol and an additional mpMRI. The primary end points were GS upgrading (GU) (>3+3) in protocol-based Bxs and protocol-based TC.ResultsOut of 76 patients, 53 (69%) had progression (PIRADS upgrade, size increase or new lesion[s]), while 18 (24%) had radiologically stable disease, and 5 (7%) had regression (PIRADS or size decrease, disappearance of lesion[s]) in repeat mpMRIs during AS. PIRADS scores of 4–5 in the initial mpMRI were associated with GU (p = 0.008) and protocol-based TC (p = 0.009). Tumour progression on repeat mpMRIs was associated with TC (p = 0.045) but not with GU (p = 1.00). PIRADS scores of 4–5 predict GU (sensitivity 0.80 [95% confidence interval (CI); 0.51–0.95, specificity 0.62 [95% CI; 0.52–0.77]) with PPV and NPV values of 0.34 (95% CI; 0.21–0.55) and 0.93 (95% CI; 0.80–0.98), respectively.ConclusionmpMRI is a useful tool not only to select but also to monitor PCa patients on AS.

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“…RALP was performed transperitoneally and the indication for extended lymphadenectomy was GS �4+3 or >5% risk of lymph node positive disease according to the Memorial Sloan Kettering nomogram [2,14]. The prostate specimens and lymph nodes were processed as described earlier [15]. All prostate material was completely mounted.…”

Section: Prostatectomy Specimen and Pathologic Analysismentioning

confidence: 99%

Prostate MRI added to CAPRA, MSKCC and Partin cancer nomograms significantly enhances the prediction of adverse findings and biochemical recurrence after radical prostatectomy

et al. 2020

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Background To determine the added value of preoperative prostate multiparametric MRI (mpMRI) supplementary to clinical variables and their role in predicting post prostatectomy adverse findings and biochemically recurrent cancer (BCR). Methods All consecutive patients treated at HUS Helsinki University Hospital with robot assisted radical prostatectomy (RALP) between 2014 and 2015 were included in the analysis. The mpMRI data, clinical variables, histopathological characteristics, and follow-up information were collected. Study end-points were adverse RALP findings: extraprostatic extension, seminal vesicle invasion, lymph node involvement, and BCR. The Memorial Sloan Kettering Cancer Center (MSKCC) nomogram, Cancer of the Prostate Risk Assessment (CAPRA) score and the Partin score were combined with any adverse findings at mpMRI. Predictive accuracy for adverse RALP findings by the regression models was estimated before and after the addition of MRI results. Logistic regression, area under curve (AUC), decision curve analyses, Kaplan-Meier survival curves and Cox proportional hazard models were used. Results Preoperative mpMRI data from 387 patients were available for analysis. Clinical variables alone, MSKCC nomogram or Partin tables were outperformed by models with mpMRI for

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Performance of transrectal prostate biopsies in detecting tumours and implications for focal therapy

Abstract: Contemporary transrectal prostate biopsies are a suboptimal tool for predicting pathological findings at RP. Approximately 40% of patients would possibly have been suitable candidates for focal or hemiablative therapies.

Cited by 6 publications

References 30 publications

New prostate cancer grade grouping system predicts survival after radical prostatectomy

New prostate cancer grade grouping system predicts survival after radical prostatectomy

Repeat multiparametric MRI in prostate cancer patients on active surveillance

Prostate MRI added to CAPRA, MSKCC and Partin cancer nomograms significantly enhances the prediction of adverse findings and biochemical recurrence after radical prostatectomy

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