Prostate cancer detection rates in different biopsy schemes. Which cores for which patients?

Cormio, Luigi; Scattoni, Vincenzo; Lorusso, Fabrizio; Perrone, A.; Fino, Giuseppe Di; Selvaggio, Oscar; Sanguedolce, Francesca; Bufo, Pantaleo; Montorsi, Francesco; Carrieri, Giuseppe

doi:10.1007/s00345-012-0989-8

Cited by 34 publications

(21 citation statements)

References 16 publications

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“…In addition, it should be pointed out that in this study we used a TRUS-guided biopsy with an extended 10-core biopsy scheme as previously described. 13,14 Although we have shown that the addition of 4 lateral peripheral samples did not increase the cancer detection rate of the 10-core biopsy scheme, 15 it is well known that with this approach it exists the possibility of undersampling the prostate, especially in the anterior and apical areas. These regions are well recognized as being difficult to sample with a transrectal approach.…”

Section: Discussionmentioning

confidence: 80%

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Absence of Bladder Outlet Obstruction Is an Independent Risk Factor for Prostate Cancer in Men Undergoing Prostate Biopsy

et al. 2016

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The purpose of this study was to investigate the relationship between bladder outlet obstruction (BOO) and the risk of being diagnosed with prostate cancer (PCa).Study population consisted of 2673 patients scheduled for the first prostate biopsy (PBx). All patients underwent uroflowmetry before PBx; those with a peak flow rate (PFR) <10 mL/s were considered to have BOO.The incidence of PCa was 41.3% (1104/2673) in the overall population and 34.1% (659/1905) in patients with serum prostate-specific antigen (PSA) ≤ 10 ng/mL. Univariate and multivariate logistic regression analyses showed that patients with BOO had a significantly (P < 0.0001) lower risk than those without BOO of being diagnosed with PCa (33.1% vs 66.9% in the overall population; 30% vs 70% in patients with PSA ≤ 10 ng/mL). As the presence of BOO was significantly correlated to a large prostate volume, another independent predictor of PBx outcome, we tested whether these parameters could be used to identify, in the subset of patients with PSA≤10 ng/mL, those who could potentially be spared from a PBx. If we would have not biopsied patients with BOO and prostate volume ≥60 mL, 14.5% of biopsies could have been avoided while missing only 6% of tumors. Only 10% of the tumors that would have been missed were high-risk cancers.In conclusion, in men undergoing PBx, the absence of BOO, as determined by a PFR ≥10 mL/s, is an independent risk factor for PCa. Our study provides ground for this simple, noninvasive, objective parameter being used, alone or in combination with prostate volume, in the decision-making process of men potentially facing a PBx.

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Section: Discussionmentioning

confidence: 80%

“…Following local anaesthesia, 13,14 TRUS was used to determine prostate volume and to guide transrectal prostate sampling according to our systematic 18-core biopsy scheme. 15 …”

Section: Introductionmentioning

confidence: 99%

Absence of Bladder Outlet Obstruction Is an Independent Risk Factor for Prostate Cancer in Men Undergoing Prostate Biopsy

et al. 2016

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“…However, only about 30–40% of men with abnormal PSA values or physical exam findings are routinely diagnosed with PC on transrectal ultrasound guided biopsy 53 . Recent studies have evaluated germline PC-risk SNPs to predict PC diagnosis on biopsy in men of European ancestry 54, 55 and different racial populations 56–58 .…”

Section: Germline Prostate Cancer Risk Variants and Biopsy Resultsmentioning

confidence: 99%

A genetic-based approach to personalized prostate cancer screening and treatment

Helfand

Catàlona²,

2015

Current Opinion in Urology

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Purpose Recent advances in sequencing technologies has allowed for the identification of genetic variants within germline DNA that can explain a significant portion of the genetic underpinnings of prostate cancer. Despite evidence suggesting that these genetic variants can be used for improved risk stratification, they have not yet been routinely incorporated into routine clinical practice. This review highlights their potential utility in prostate cancer screening. Recent Findings There are now almost 100 genetic variants, called single nucleotide polymorphisms (SNPs) that have been recently found to be associated with the risk of developing prostate cancer. In addition, some of these prostate cancer risk SNPs also have been found to influence PSA expression levels and potentially aggressive disease. Summary Incorporation of panels of prostate cancer risk SNPs into clinical practice offers potential to provide improvements in 1) patient selection for prostate cancer screening 2) PSA interpretation (e.g. by correcting for the presence of SNPs that influence PSA expression levels, 3) decision for biopsy (using PC-risk SNPs) and possibly the 4) decision for treatment. A proposed clinical algorithm incorporating these PC-risk SNPs is discussed.

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“…Since a limited number of cores might not decrease the chance of obtaining the small foci and it was desirable to avoid adverse effects, in the present study the biopsies were performed via the perineal route, collecting ≥12 biopsy cores, depending on prostate volume [18]. The perineal route is advantageous compared to the rectal route because it reduces the likelihood of missing some foci [19].…”

Section: Discussionmentioning

confidence: 99%

Management of Men with a Suspicion of Prostate Cancer after Negative Initial Prostate Biopsy Results

et al. 2014

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Introduction: For men with elevated prostate-specific antigen (PSA), appropriate management after negative prostate biopsy remains controversial. After determining PSA kinetics, subsequent follow-up was considered. Patients and Methods: A total of 115 cases with negative repeat biopsy were followed by evaluating PSA kinetics and ratio of percent free PSA (F/T) and by performing second repeat biopsy. Results: Eighteen cancer cases were diagnosed. Shorter PSA doubling times and faster velocities were found in cancer cases compared with cases without cancer. We observed a clear decrease in F/T among cancer cases. Conclusions: To avoid unnecessary repeat biopsies, cases with a suspicion of cancer after negative biopsy can be divided into two groups: one that requires additional biopsies and one with an average change in PSA of <1 ng/ml/year and no change in F/T, which is recommended for surveillance as stable disease without biopsy over a specified time period.

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Prostate cancer detection rates in different biopsy schemes. Which cores for which patients?

Cited by 34 publications

References 16 publications

Absence of Bladder Outlet Obstruction Is an Independent Risk Factor for Prostate Cancer in Men Undergoing Prostate Biopsy

Absence of Bladder Outlet Obstruction Is an Independent Risk Factor for Prostate Cancer in Men Undergoing Prostate Biopsy

A genetic-based approach to personalized prostate cancer screening and treatment

Management of Men with a Suspicion of Prostate Cancer after Negative Initial Prostate Biopsy Results

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