Evidence map›Paper›PMID 24513649›Full record

ArticleProstate cancer and prostatic diseases2014

Left lobe of the prostate during clinical prostate cancer screening: the dark side of the gland for right-handed examiners.

G Ploussard, N Nicolaiew, P Mongiat-Artus, S Terry, Y Allory, F Vacherot, C-C Abbou, F Desgrandchamps, L Salomon, A de la Taille

Abstract read
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Article in Prostate cancer and prostatic diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
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0citing papers in PubMed
–field-weighted citation impact, top 84% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

G Ploussard1] INSERM U955 Eq07 Departments of Urology and Pathology, APHP, CHU Henri Mondor, Créteil, France [2] Department of Urology, APHP, CHU Saint-Louis, Paris, France.
N NicolaiewINSERM U955 Eq07 Departments of Urology and Pathology, APHP, CHU Henri Mondor, Créteil, France.
P Mongiat-ArtusDepartment of Urology, APHP, CHU Saint-Louis, Paris, France.
S TerryINSERM U955 Eq07 Departments of Urology and Pathology, APHP, CHU Henri Mondor, Créteil, France.
Y AlloryINSERM U955 Eq07 Departments of Urology and Pathology, APHP, CHU Henri Mondor, Créteil, France.
F VacherotINSERM U955 Eq07 Departments of Urology and Pathology, APHP, CHU Henri Mondor, Créteil, France.
C-C AbbouINSERM U955 Eq07 Departments of Urology and Pathology, APHP, CHU Henri Mondor, Créteil, France.
F DesgrandchampsDepartment of Urology, APHP, CHU Saint-Louis, Paris, France.
L SalomonINSERM U955 Eq07 Departments of Urology and Pathology, APHP, CHU Henri Mondor, Créteil, France.
A de la TailleINSERM U955 Eq07 Departments of Urology and Pathology, APHP, CHU Henri Mondor, Créteil, France.
Centre Hospitalier Universitaire Henri-Mondor · FRAssistance Publique – Hôpitaux de Paris · FRInserm · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe predictive value of the abnormality side during digital rectal examination (DRE) has never been studied, suggesting that physicians examined the left lobe of the gland as well as the right lobe. We aimed to assess the predictive value of the side of DRE abnormality for prostate cancer (PCa) detection and aggressiveness in right-handed urologists.

methodsAn analysis of a prospective database was carried out that included all consecutive men undergoing prostate biopsies between 2001 and 2012. The main end point was the predictive value of the abnormality side during DRE for cancer detection in clinically suspicious unilateral T2 disease. The diagnostic performance of left- versus right-sided abnormality was also assessed in terms of sensitivity, specificity and negative/positive predictive values.

resultsOverall, 308 patients had a suspicious unilateral clinical disease (detection rate 57.5%). The cancer detection rate was significantly higher in case of left-sided compared with right-sided clinical T2 stage (odds ratio 2.1). In case of left-sided disease, the number of positive cores, the rate of perineural invasion, the rate of primary grade 4 pattern and the percentage of cancer involvement per core were significantly higher compared with those reported for right-sided disease. The predictive value of abnormality laterality for cancer detection and aggressiveness remained statistically independent in multivariate models. The positive predictive value for cancer detection was 64.6 in case of suspicious left-sided disease versus 46.9 in case of right-sided disease.

conclusionsThe risks of detecting PCa and aggressive disease on biopsy are significantly higher when DRE reveals a suspicious left-sided clinical disease as compared with right-sided disease. Right-handed physicians should be aware of this variance in diagnostic performance and potential underdetection of left-sided clinical disease, and should improve their examination of the left lobe of the gland by conducting longer exams or changing the patient's position.

Indexed as

AgedBiopsyDigital Rectal ExaminationEarly Detection of CancerHumansMaleMiddle AgedProspective StudiesProstateProstate-Specific AntigenProstatic NeoplasmsProstate-Specific Antigen

Identifiers

PMID24513649
OpenAlexW2080260118

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.