The Potential Impact of Prostate Volume in the Planning of Optimal Number of Cores in the Systematic Transperineal Prostate Biopsy

Ficarra, Vincenzo; Novella, Giovanni; Novara, Giacomo; Galfano, Antonio; Pea, Maurizio; Martignoni, Guido; Artibani, Walter

doi:10.1016/j.eururo.2005.08.008

Cited by 74 publications

(44 citation statements)

References 21 publications

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“…This hypothesis is supported by studies demonstrating a negative correlation between total prostate volume and biopsy yield, 1,2 and those in which larger prostate volume was a predictor of the positivity of repeat biopsy as well as the negativity of initial biopsy. 3,4 These findings led to the suggestion that biopsy core number should be adjusted according to patient age and prostate volume to optimize sampling.…”

mentioning

confidence: 77%

“…As would be expected, the recommended number of cores increases with prostate gland size, consistent with clinical study data. 1,3,4 The modeling approaches in this study are similar to those of Vashi et al 8 but they differ in specifics. Each entails a multifocality model and each includes the total prostate volume and the number of biopsy cores as input variables.…”

Section: Discussionmentioning

confidence: 98%

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Quantifying the Impact of Prostate Volumes, Number of Biopsy Cores and 5α-Reductase Inhibitor Therapy on the Probability of Prostate Cancer Detection Using Mathematical Modeling

et al. 2007

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Purpose: Previous studies demonstrated a negative correlation between prostate volume and biopsy yield. By decreasing prostate volume 5␣-reductase inhibitors may enhance cancer detection, which may explain the greater detection of high grade tumors in the finasteride arm of the Prostate Cancer Prevention Trial. Materials and Methods: A mathematical model was constructed to analyze the effects of prostate and tumor volumes, and biopsy core number on cancer detection. The effects of the volume reduction observed with finasteride in the Prostate Cancer Prevention Trial were also modeled, as was the potential reduction in tumor volume needed to explain the observed difference in prostate cancer detection. The model was also applied to the Reduction by Dutasteride of Prostate Cancer Events study. Results: A higher number of biopsies are required to ensure a detection probability of 0.90 or greater in larger glands or with smaller tumors. In the Prostate Cancer Prevention Trial for a tumor volume of 1 cc a 17% increase in the detection rate in the finasteride arm would be predicted if there was no change in tumor volume, likewise the rate would be 11% to 17% for the dutasteride arm of the Reduction by Dutasteride of Prostate Cancer Events study. The calculated reduction in tumor volume needed to explain the difference in cancer detection between the finasteride and placebo arms of the Prostate Cancer Prevention Trial would be 51% to 66%. Conclusions: This model provides guidance on the optimal number of biopsy cores that accord with an earlier model. These findings also suggest that, if there were no reduction in tumor volume, 5␣-reductase inhibitor therapy could lead to excess cancer detection, including high grade tumors.

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confidence: 77%

Section: Discussionmentioning

confidence: 98%

Quantifying the Impact of Prostate Volumes, Number of Biopsy Cores and 5α-Reductase Inhibitor Therapy on the Probability of Prostate Cancer Detection Using Mathematical Modeling

et al. 2007

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“…Thus, there has been increasing interest in defining more accurate prostate biopsy strategies in order to improve the PCa detection rate. The benefits of increasing the number of biopsy cores and/or expanding the number of regions sampled have been demonstrated previously (5,6); however, it has also been suggested that a 10-to 12-core initial biopsy may miss PCa in almost a third of cases (7,8). Saturation prostate biopsy, which consists of ≥20 cores, has been developed to improve the detection rate of PCa in the context of repeat biopsies, radically altering the general concept of prostate biopsy (9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Analysis of repeated 24-core saturation prostate biopsy: Inverse association between asymptomatic histological inflammation and prostate cancer detection

et al. 2016

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“…3 When compared to TR biopsy, studies on extended transperineal (TP) biopsy have been relatively limited and there has been no consensus on standard extended TP biopsy protocol. [4][5][6][7][8][9][10][11][12][13] The lack of standardization at the moment is related to both TP and TR approaches.…”

Section: Introductionmentioning

confidence: 99%

Direct comparison between transrectal and transperineal extended prostate biopsy for the detection of cancer

et al. 2007

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Aim:To establish whether extended transrectal (TR) and extended transperineal (TP) biopsies are equivalent in detecting prostate cancer. Methods: Due to an elevated prostate-specific antigen (PSA) greater than 2.5 ng/mL or abnormal digital rectal examination findings, 783 men underwent a transrectal ultrasound-guided three-dimensional 26-core biopsy, a combination of TR 12-core and TP 14-core biopsies. Using recursive partitioning, the best combination of sampling sites that gave the highest cancer detection rate at a given number of biopsy cores was selected either with a TR or a TP approach. The cancer detection rate and characteristics of detected cancers were compared between the TP 14-core and the TR 12-core biopsies and between selected subset biopsy schemes. Results: Prostate cancer was detected in 283 of the 783 men (36%). There was no statistical difference in cancer detection rate or in the characteristics of detected cancers between TP 14-core and TR 12-core biopsies. As far as the best combination of sampling sites was selected , there was no statistical difference in cancer detection rates or in the characteristics of detected cancers between the TP and the TR subset biopsy schemes up to 12 cores. TP and TR biopsies performed equally, regardless of a history of negative biopsy, a digital rectal examination finding, the PSA level or the prostate volume. Conclusions: We demonstrated for the first time that extended TP biopsy is as effective as its TR counterpart in detecting cancer and the characteristics of detected cancers, as far as sampling sites are selected to maximize the cancer detection rate.

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The Potential Impact of Prostate Volume in the Planning of Optimal Number of Cores in the Systematic Transperineal Prostate Biopsy

Cited by 74 publications

References 21 publications

Quantifying the Impact of Prostate Volumes, Number of Biopsy Cores and 5α-Reductase Inhibitor Therapy on the Probability of Prostate Cancer Detection Using Mathematical Modeling

Quantifying the Impact of Prostate Volumes, Number of Biopsy Cores and 5α-Reductase Inhibitor Therapy on the Probability of Prostate Cancer Detection Using Mathematical Modeling

Analysis of repeated 24-core saturation prostate biopsy: Inverse association between asymptomatic histological inflammation and prostate cancer detection

Direct comparison between transrectal and transperineal extended prostate biopsy for the detection of cancer

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