Appropriate Patient Selection in the Focal Treatment of Prostate Cancer: The Role of Transperineal 3-Dimensional Pathologic Mapping of the Prostate—A 4-Year Experience

Barzell, Winston; Melamed, Myron R.

doi:10.1016/j.urology.2007.06.1126

Cited by 180 publications

(105 citation statements)

References 39 publications

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“…3,4 The template transperineal mapping biopsy or saturation biopsy technique should be more sensitive, but are more invasive than TRUS-guided systematic biopsy. 5 Recently, there have been several publications investigating whether multiparametric magnetic resonance imaging (mpMRI) techniques improve the diagnostic accuracy of CSPC. [6][7][8] To determine the location of prostate cancer, the mpMRI examination combines imaging features from at least three of the following data sets: T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), dynamic contrast-enhanced T1-weighted imaging (DCE-MRI), and proton spectroscopy (MRSI).…”

Section: Introductionmentioning

confidence: 99%

Evidence-based guideline recommendations on multiparametric magnetic resonance imaging in the diagnosis of prostate cancer: A Cancer Care Ontario clinical practice guideline

Haider

Yao

Loblaw

et al. 2017

CUAJ

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Cite as: Can Urol Assoc J 2017;11(1-2):E1-7. http://dx.doi.org/10.5489/cuaj.3968 Published online January 12, 2017 AbstractThis clinical guideline focuses on: 1) the use of multiparametric magnetic resonance imaging (mpMRI) in diagnosing clinically significant prostate cancer (CSPC) in patients with an elevated risk of CSPC and who are biopsy-naïve; and 2) the use of mpMRI in diagnosing CSPC in patients with a persistently elevated risk of having CSPC and who have a negative transrectal ultrasound (TRUS)-guided systematic biopsy.

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Section: Introductionmentioning

confidence: 99%

Evidence-based guideline recommendations on multiparametric magnetic resonance imaging in the diagnosis of prostate cancer: A Cancer Care Ontario clinical practice guideline

Haider

Yao

Loblaw

et al. 2017

CUAJ

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“…About half of the patients' tumors were localized in the anterior lob. [17,18] MR image assisted transperineal biopsy is not superior to ultrasound assisted biopsy in patients whose tumors are low grade and volume similar to AS patients. [19] But MR image assisted and 3D mapping method has shown that 25% of AS patients have GS ≥7 tumor and 61% of them are bilateral.…”

Section: Discussionmentioning

confidence: 91%

The importance of active surveillance, and immediate re-biopsy in low-risk prostate cancer: The largest series from Turkey

Bayar

Horasanlı

Acinikli

et al. 2016

Turkish Journal of Urology

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Objective: To evaluate long-term outcomes of active surveillance (AS) applied in low-risk prostate cancer patients, and the impact of re-biopsy results on the prediction of progression. Material and methods:In our clinic, patients who had undergone AS for low-risk localized prostate cancer between the years 2005-2013 were included in the study. Our AS criteria are Gleason score ≤6, prostate-specific antigen (PSA) level <10 ng/mL, number of positive cores <3, maximum cancer involvement ratio <50% each core. Immediate re-biopsy (within 3 months) was performed to 65 patients who accepted AS. Finally, 43 patients who met re-biopsy criteria were included in the study. Prostate biopsy specimens were harvested from 12 cores under the guidance of transrectal ultrasound (TRUS). Re-biopsy was performed within 3 months (1-12 weeks). In rebiopsy, a total of 20 core biopsies were performed including the far lateral (6 cores) and transition zone (2 cores) in addition to standard 12 core biopsy. Our follow-up protocol is PSA measurement and digital rectal examination (DRE) every 3 months within the first 2 years, than every 6 months. Control biopsies was performed one year later and once upon every 3 years to patients whose PSA levels and DREs were normal at follow-up visits. More than 2 tumor invaded cores or 50% tumor in one core, and Gleason score exceeding 6 points were accepted as indications for definitive treatment. Patients were divided into two groups by re-biopsy results and compared according to the time to progression. We have done multivariate regression analysis to predict prognosis by using data on age, PSA level, and detection of tumor in re-biopsy specimens.Results: Patients' median age was 61 years and PSA level was 5 (2.7-9) ng/mL. Tumor was detected in 22 (34%) patients at re-biopsy and they underwent definitive treatment. Additionally tumor was detected in 9 patients, but active surveillance was maintained because their pathologic results met active surveillance criteria. Median follow time was 42 (24-117) months. Definitive treatment was performed in 9 (21%) patients. PSA recurrence was not detected in none of 9 patients during 38 months of follow up. Only the presence of tumor in re-biopsy specimens was found predictor of disease progression in multivariate analysis. Conclusion:We think that AS is safe method for low-risk localized prostate cancer patients, if it is performed in compliance with certain criteria and regular follow up, and early re-biopsy can be useful either during early period or long term follow-up.

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“…Template transperineal prostate mapping biopsies might provide more exact information about the spatial tumor distribution of PCa and might accurately identify unilateral cancer for the purpose of FT (13,19,20). When used with a 5mm sampling frame, this approach can rule in and rule out PCa foci of 0.5cc and 0.2cc volumes, with 90% certainty (19).…”

Section: Discussionmentioning

confidence: 99%

Transperineal versus transrectal prostate biopsy for predicting the final laterality of prostate cancer: are they reliable enough to select patients for focal therapy? Results from a multicenter international study

et al. 2014

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ARTICLE INFO ______________________________________________________________ ______________________Objectives: To compare the concordance of prostate cancer (PCa) laterality between the extended transperineal (TP) or transrectal (TR) prostate biopsy (BP) and radical prostatectomy (RP) specimens. To identify predictors of laterality agreement between BP and RP. Materials and Methods: Data from 533 consecutive patients with PCa (278 TP and 255 TR-diagnosed) treated with RP were analyzed. A 12-core technique was used for both TP and TR biopsies. Additional cores were obtained when necessary.Results: Overall, the percentage of agreement of PCa laterality between BP and RP was 60% (K = 0.27, p < 0.001). However, the RP confirmation of unilaterality at BP was obtained in just 33% of the cases. Considering the concordance on bilaterality as the "target" of our analysis, the sensitivity and specificity were 54.3% and 98.2%, respectively, with TP and 47.5% and 92.5%, respectively with TR. Focusing on patients with unilaterality at biopsy, none of the evaluated preoperative variables (biopsy technique, age, total positive biopsy cores, PSA, prostate volume, Gleason score on biopsy) were able to predict RP bilaterality in the multivariate analyses. Conclusions: Most of the patients with unilateral involvement at BP harbored bilateral PCa after RP. TR and TP biopsy showed no difference in their capacity to predict the concordance of tumor laterality at RP. None of the preoperative evaluated variables can predict the tumor laterality at RP. Using BP unilaterality to include patients in focal therapy (FT) protocols may hinder the oncologic efficacy of FT.

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Appropriate Patient Selection in the Focal Treatment of Prostate Cancer: The Role of Transperineal 3-Dimensional Pathologic Mapping of the Prostate—A 4-Year Experience

Cited by 180 publications

References 39 publications

Evidence-based guideline recommendations on multiparametric magnetic resonance imaging in the diagnosis of prostate cancer: A Cancer Care Ontario clinical practice guideline

Evidence-based guideline recommendations on multiparametric magnetic resonance imaging in the diagnosis of prostate cancer: A Cancer Care Ontario clinical practice guideline

The importance of active surveillance, and immediate re-biopsy in low-risk prostate cancer: The largest series from Turkey

Transperineal versus transrectal prostate biopsy for predicting the final laterality of prostate cancer: are they reliable enough to select patients for focal therapy? Results from a multicenter international study

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