ArticleTranslational andrology and urology2020
Evolution of prostate cancer diagnosis: retrospective analysis of magnetic resonance imaging/ultrasound fusion guided biopsies protocol in routine practice and patients management.
Article in Translational andrology and urology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMagnetic resonance imaging (MRI) is today strongly recommended in prostate cancer (PCa) diagnosis. Therefore, MRI/ultrasound (MRI/US) fusion-guided biopsy is becoming the new standard patients management.
methodsWe report our experience during the last 4 years using this technique, with a protocol of 6 random cores (instead of the most used 12 cores protocol) associated to the target cores (2 to 3 per lesion). Our study involved 236 patients including real life routine practice: biopsy naïve patients (n=107), patients with previous negative standard prostate biopsies (n=67) and patients in PCa active surveillance (n=62). Finally, 76 patients have a robotic radical prostatectomy.
resultsMean age of the population was 66 years. Median PSA was 8.5 ng/mL. Overall and significant cancer detection were respectively 66.6% and 38.5%, with a large difference considering biopsy history: 63.5% in biopsy naïve patient, 53.7% in patient with previous negative biopsies and 82.3% in patients under active surveillance. Targeted biopsies missed 28 cancers among 8 were significant and standard biopsies missed 33 cancers among 14 were significant. Moreover, concordance between biopsy samples and radical prostatectomy specimens was evaluated at 80%.
conclusionsComparing to literature data, similar results were observed in our retrospective study, even with reduced random cores, suggesting a real change in patients management in particular in active surveillance group with a reclassification rate of 56.4% using the Epstein criteria.
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