Prostate Rebiopsy Is a Poor Surrogate of Treatment Efficacy in Localized Prostate Cancer

Svetec, David A.; McCabe, Kevin W.; Peretsman, Samuel J.; Klein, Eric A.; Levin, Howard S.; Optenberg, Scott A.; Thompson, Ian M.

doi:10.1097/00005392-199805000-00052

Cited by 72 publications

(24 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In 1998, Svetec and colleagues performed an ex-vivo sextant biopsy on 90 prostates removed for biopsy-proven cancer and found that 45.6% were negative. 27 Similar results have been reported by Fink and colleagues in 2001. They compared the cancer detection of two consecutive sets of ex-vivo prostate biopsies using either the sextant or the 10-core technique.…”

supporting

confidence: 87%

How reliable is 12-core prostate biopsy procedure in the detection of prostate cancer?

Şerefoğlu¹,

Altinova²,

Uğraş³

et al. 2013

CUAJ

127

View full text Add to dashboard Cite

E293Cite as: Can Urol Assoc J 2013;7(5-6):e293-8. http://dx.doi.org/10.5489/cuaj.11224 Published online May 13, 2013 (early released March 2, 2012). AbstractIntroduction: Prostate biopsies incur the risk of being false-negative and this risk has not yet been evaluated for 12-core prostate biopsy. We calculated the false-negative rate of 12-core prostate biopsy and determined the patient characteristics which might affect detection rate. Methods: We included 90 prostate cancer patients (mean age of 64, range: 49-77) diagnosed with transrectal ultrasound guided 12-core prostate biopsy between December 2005 and April 2008. All patients underwent radical retropubic prostatectomy and the 12-core prostate biopsy procedure was repeated on surgical specimen ex-vivo. Results of preoperative and postoperative prostate biopsies were compared. We analyzed the influence of patient age, prostate weight, serum prostate-specific antigen (PSA) level, free/ total PSA ratio, PSA density and Gleason score on detection rate. Results: In 67.8% of patients, prostate cancer was detected with repeated ex-vivo biopsies using the same mapping postoperatively. We found an increase in PSA level, PSA density and biopsy Gleason score; patient age, decreases in prostate weight and free/ total PSA ratio yielded higher detection rates. All cores, except the left-lateral cores, showed mild-moderate or moderate internal consistency. Preoperative in-vivo biopsy Gleason scores remained the same, decreased and increased in 43.3%, 8.9% and 47.8% of patients, respectively, on final specimen pathology. Conclusions: The detection rate of prostate cancer with 12-core biopsy in patients (all of whom had prostate cancer) was considerably low. Effectively, repeat biopsies can still be negative despite the patient's reality of having prostate cancer. The detection rate is higher if 12-core biopsies are repeated in younger patients, patients with high PSA levels, PSA density and Gleason scores, in addition in patients with smaller prostates, lower free/total PSA ratios. IntroductionThe most accurate way to detect cancer cells inside the prostate gland is the surgical removal and histopathological examination of the entire gland. As this approach is clinically inapplicable to each patient with suspicious findings, prostate biopsy is accepted as the best diagnostic technique to detect prostate cancer. Indeed, the introduction of transrectal ultrasound (TRUS)-guided systematic sextant biopsy method by Hodge and colleagues in 1989 revolutionized the early diagnosis of prostate cancer. 1 However, there are two shortcomings of this technique. Firstly, the amount of tissue sampled during prostate biopsy is limited and cancer cells can be missed. Secondly, the way prostate biopsy accurately diagnoses prostate cancer is unclear and various prostate biopsy regimens were introduced to optimize the detection rate. [2][3][4] Presumably, the most extensive and invasive regimens had better detection rates, compared to biopsy regimens with less biopsy cores. These regimens ar...

show abstract

supporting

confidence: 87%

How reliable is 12-core prostate biopsy procedure in the detection of prostate cancer?

Şerefoğlu¹,

Altinova²,

Uğraş³

et al. 2013

CUAJ

127

View full text Add to dashboard Cite

show abstract

“…In a large study, transrectal US was found to have only a 15.2% positive predictive value in detection of cancers versus 28% for DRE; therefore, both techniques are unable to allow differentiation of an abundance of benign processes mimicking prostate cancer from true-positive cases. Transrectal US used in the absence of palpable findings has a low sensitivity of 30%-45%, meaning that less than one-half of the ultimately diagnosed cancers can be visualized with transrectal US, even if the improved systematic sextant approach is used (9).…”

Section: Transrectal Us and Guided Biopsymentioning

confidence: 99%

Advancements in MR Imaging of the Prostate: From Diagnosis to Interventions

Bonekamp¹,

Jacobs²,

El-Khouli³

et al. 2011

RadioGraphics

216

161

View full text Add to dashboard Cite

Prostate cancer is the most frequently diagnosed cancer in males and the second leading cause of cancer-related death in men. Assessment of prostate cancer can be divided into detection, localization, and staging; accurate assessment is a prerequisite for optimal clinical management and therapy selection. Magnetic resonance (MR) imaging has been shown to be of particular help in localization and staging of prostate cancer. Traditional prostate MR imaging has been based on morphologic imaging with standard T1-weighted and T2-weighted sequences, which has limited accuracy. Recent advances include additional functional and physiologic MR imaging techniques (diffusionweighted imaging, MR spectroscopy, and perfusion imaging), which allow extension of the obtainable information beyond anatomic assessment. Multiparametric MR imaging provides the highest accuracy in diagnosis and staging of prostate cancer. In addition, improvements in MR imaging hardware and software (3-T vs 1.5-T imaging) continue to improve spatial and temporal resolution and the signal-to-noise ratio of MR imaging examinations. Another recent advancement in the field is MR imaging guidance for targeted prostate biopsy, which is an alternative to the current standard of transrectal ultrasonographyguided systematic biopsy. Abbreviations: ADC = apparent diffusion coefficient, BPH = benign prostatic hyperplasia, DCE = dynamic contrast-enhanced, DRE = digital rectal examination, EES = extracellular-extravascular space, PSA = prostate-specific antigen, ROI = region of interest, SNR = signal-to-noise ratio, TKCM = tracer kinetic compartmental model

show abstract

“…However, concerns have arisen that the sextant biopsy method undersamples the prostate [15] , and consequently may fail to detect a significant proportion of clinically important tumors [16] . Moreover, Svetec et al [17] proved that the standard sextant biopsy technique could 'miss' more than 45% of already confirmed cancers by performing sextant biopsies in glands obtained from radical prostatectomy specimens. Similarly, Fink et al [18] with a more extensive study on ex vivo sextant and 10-core biopsy sets on radical prostatectomy specimens, proved that the 10-core prostate biopsy was superior to the commonly used sextant technique and could spare patients from unnecessarily repeated biop- sies.…”

Section: Discussionmentioning

confidence: 99%

Impact of Additional Sampling in the TRUS-Guided Biopsy for the Diagnosis of Prostate Cancer

Stamatiou

Alevizos

Karanasiou³

et al. 2007

Urol Int

View full text Add to dashboard Cite

Aim: To evaluate the diagnostic value of 10+ systematic sampling technique when performing transrectal ultrasound-guided (TRUS) prostate biopsy, compared with the sextant biopsy technique for patients with suspected prostate cancer. Methods: 286 patients with suspected prostate cancer were included in the study. Patients were eligible for the study if they had serum levels of prostate-specific antigen (PSA) >4 ng/ml or ratio PSA <0.25 and/or an abnormal digital rectal examination (DRE). The population sample was divided in three groups: (1) those with positive PSA, PSA ratio and DRE (70 patients); (2) those with positive PSA and PSA ratio but normal DRE (178 patients), and (3) those with positive PSA and PSA ratio, positive PSA velocity and a negative biopsy in the previous 6-month period (38 patients). In addition to the conventional sextant prostate biopsy cores, four more biopsies were obtained from the lateral peripheral zone (10 core biopsy protocol). Additional cores (total of 12–14) were also randomly selected in case of larger prostates (>60 ml) or from suspicious foci revealed by transrectal ultrasound. All additional biopsy cores were submitted separately to the pathological department. Results: Cancer was detected in 55.7% (39/70) and 69% (48/70) of the patients (for sextant core and for the extended biopsy protocols, respectively) in the first study group, 11% (20/178) and 23% (41/178) of the patients (for the sextant and the extended biopsy protocols, respectively) in the second study group, and 42% (16/38) and 63% (24/38) of the patients (for the sextant and the extended biopsy protocols, respectively) in the third study group. The addition of the lateral peripheral zone (PZ) of the prostate to the sextant biopsy showed a 23, 105 and 50% increase in the number of cancers diagnosed in the first, second and third study groups, respectively. The improvement of cancer detection rate (sensitivity) was statistically significant for all groups evaluated. Conclusion: The 10+ systematic TRUS-guided prostate biopsy improves the detection rate of prostate cancer compared to the sextant biopsy technique alone, especially when performed in men with positive PSA, PSA ratio, and negative DRE.

show abstract

Prostate Rebiopsy Is a Poor Surrogate of Treatment Efficacy in Localized Prostate Cancer

Cited by 72 publications

References 9 publications

How reliable is 12-core prostate biopsy procedure in the detection of prostate cancer?

How reliable is 12-core prostate biopsy procedure in the detection of prostate cancer?

Advancements in MR Imaging of the Prostate: From Diagnosis to Interventions

Impact of Additional Sampling in the TRUS-Guided Biopsy for the Diagnosis of Prostate Cancer

Contact Info

Product

Resources

About