Significant Discrepancies Between Diagnostic and Pathologic Gleason Sums in Prostate Cancer: The Predictive Role of Age and Prostate-Specific Antigen

Isariyawongse, Brandon K.; Sun, Leon; Bañez, Lionel L.; Robertson, Cary N.; Polascik, Thomas J.; Maloney, Kelly E.; Donatucci, Craig F.; Albala, David; Mouraviev, Vladimir; Madden, John F.; Moul, Judd W.

doi:10.1016/j.urology.2008.02.021

Cited by 57 publications

(35 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For each biopsy core, the template coordinate and the offset from base were recorded. Biopsy regions included posterior prostate (3,4,12,13,21,22), posterior lateral (2,5,11,14,20,23), anterior lateral (1,6,9,10,15,16), anterior apex (19,24), and TZ (7,8,17,18) After completion of all sampling, patients underwent cystoscopic evaluation.…”

Section: Methodsmentioning

confidence: 99%

“…3 The prospect of undergrading particularly affects men who are considering a course of close observation for suspected minimal disease identified on biopsy. Epstein et al 7 evaluated prostatectomy specimens of 103 men believed to have insignificant cancer based on an initial TRUS biopsy.…”

Section: Potential Implicationsmentioning

confidence: 99%

“…1,2 In addition, initial biopsy pathology frequently underestimates the Gleason score that would be assigned based on full gland evaluation. 3 In an effort to reduce false-negative rates and improve accuracy of staging, investigators have explored alternative biopsy approaches, including increasing the number of cores sampled and changing access with a transperineal approach.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Performance of transperineal template-guided mapping biopsy in detecting prostate cancer in the initial and repeat biopsy setting

Taira

Merrick

Galbreath

et al. 2009

Prostate Cancer Prostatic Dis

262

171

View full text Add to dashboard Cite

Transrectal ultrasound (TRUS) biopsy can miss 20-30% of clinically significant cancers. We evaluate an alternative approach-transperineal template-guided mapping biopsy (TTMB) in the initial and repeat biopsy setting. From January 2005 through September 2008, 373 consecutive men underwent TTMB (294 men with X1 prior negative biopsy and 79 men as the initial biopsy). The location of each positive biopsy core, number of positive cores, and percent involvement of each core was recorded. Cancer detection rate for the initial biopsy was 75.9%. For men with 1, 2, and X3 prior negative biopsies detection rates were 55.5%, 41.7%, and 34.4%, respectively. In all, 55.5% of the cancers identified were Gleason X7. The majority of the cancers were multifocal. There was no significant change in the number of positive cores or Gleason score as the number of prior biopsies increased. The anterior and apical aspects of the prostate were among the most common cancer locations. TTMB provides a high rate of cancer detection as initial and repeat biopsy. TTMB was particularly effective at diagnosing anterior and apical cancer. TTMB may have particular application for men considering active surveillance, with prior negative TRUS biopsies, and those considering subtotal gland or other minimally invasive treatments.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Potential Implicationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Performance of transperineal template-guided mapping biopsy in detecting prostate cancer in the initial and repeat biopsy setting

Taira

Merrick

Galbreath

et al. 2009

Prostate Cancer Prostatic Dis

262

171

View full text Add to dashboard Cite

show abstract

“…Isariyawongse et al reported significant discrepancies between diagnostic and pathologic Gleason sum scores in PCa and noted the predictive role of age and prostate-specific antigen [20]. A more recent study by Dinh et al into the incidence and predictors of upgrading and upstaging among 10,000 contemporary patients with low risk PCa found that following prostatectomy, 44% of cases was upgraded and 9.7% were up staged.…”

Section: Discussionmentioning

confidence: 99%

Active Surveillance Following Modified Transperineal Template Guided Saturation Biopsy Demonstrates a Low Rate of Progression and Conversion to Radical Treatment, with Age and PSA Associated with Upgrading, Upstaging and Treatment

Sarkar¹,

Ekwueme²,

Parr³

2017

Adv Cancer Prev

View full text Add to dashboard Cite

Objectives: To evaluate outcomes in patients embarking upon active surveillance for Prostate cancer (Pca) following tumour characterisation by modified transperineal template guided saturation biopsy. Materials and Methods:Of 500 patients with initial negative conventional transrectal ultrasound guided prostate biopsy underwent transperineal template guided saturation biopsy, detected cancer in 276 (55%). Of these, 30 (11%) elected for active surveillance. Another 158 patients considering active surveillance after initial positive transrectal ultrasound guided biopsy underwent confirmatory transperineal template guided saturation biopsy, with 43 (27%) subsequently electing for active surveillance. A total of 73 patients from these two groups (median age 63 years) were, thus, enrolled for active surveillance. Follow up consisted of 3 monthly PSA and DRE, offering repeat Multi-parametric MRI and repeat transperineal template Guided Saturation Biopsy, at 24 months, or on suspicion of progression.Results: At a median follow up of 58 months, 59 patients have undergone repeat Multi-parametric MRI. Radiological progression was identified in 6 (8%), Gleason upgrading on repeat transperineal template guided saturation biopsy, in 14 (19%). Six (8%) have undergone radical treatments. Age >60 yrs and PSA >5 ng/mL were associated with upgrading and upstaging (p<0.05). Conclusion:A large proportion of patients initially considering active surveillance dropped out following confirmatory transperineal template Guided saturation biopsy, however, in those electing for active surveillance after transperineal template guided saturation biopsy, progression rates are low and related to age and presenting PSA.

show abstract

“…However, many urologists and patients are reluctant to monitor their cancer on active surveillance due to concerns for delaying treatment or potentially missing treatment of aggressive cancer during a window of cure. Evidence for inadequacy of staging and risk stratification is demonstrated by the increase in Gleason Grade from Gleason 6-7 or higher in 40% of patients treated with radical prostatectomy (RP) (13,14). Thus, significant discrepancies between prostate needle biopsy and RP specimens may be attributed to diagnostic pitfalls as only 2% of the prostate is sampled with a biopsy (15).…”

mentioning

confidence: 99%

Circulating microRNA signature for the diagnosis of very high-risk prostate cancer

Alhasan

Scott

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

125

View full text Add to dashboard Cite

We report the identification of a molecular signature using the Scano-miR profiling platform based on the differential expression of circulating microRNAs (miRNA, miR) in serum samples specific to patients with very high-risk (VHR) prostate cancer (PCa). Five miRNA PCa biomarkers (miR-200c, miR-605, miR-135a*, miR-433, and miR-106a) were identified as useful for differentiating indolent and aggressive forms of PCa. All patients with VHR PCa in the study had elevated serum levels of miR-200c. Circulating miR-433, which was differentially expressed in patients with VHR versus low-risk (LR) forms of PCa, was not detectable by quantitative real-time PCR in samples from healthy volunteers. In blind studies, the five miRNA PCa biomarkers were able to differentiate patients with VHR PCas from those with LR forms as well as healthy individuals with at least 89% accuracy. Biological pathway analysis showed the predictive capability of these miRNA biomarkers for the diagnosis and prognosis of VHR aggressive PCa.

show abstract

Significant Discrepancies Between Diagnostic and Pathologic Gleason Sums in Prostate Cancer: The Predictive Role of Age and Prostate-Specific Antigen

Cited by 57 publications

References 17 publications

Performance of transperineal template-guided mapping biopsy in detecting prostate cancer in the initial and repeat biopsy setting

Performance of transperineal template-guided mapping biopsy in detecting prostate cancer in the initial and repeat biopsy setting

Active Surveillance Following Modified Transperineal Template Guided Saturation Biopsy Demonstrates a Low Rate of Progression and Conversion to Radical Treatment, with Age and PSA Associated with Upgrading, Upstaging and Treatment

Circulating microRNA signature for the diagnosis of very high-risk prostate cancer

Contact Info

Product

Resources

About