Can prostate biopsies predict suitability for nerve‐sparing radical prostatectomy?

Connolly, Sheelah; O’Malley, Kiaran; O'Brien, Anne; Kelly, D. G.; Mulvin, D.; Quinlan, David M.

doi:10.1080/00365590310006237

Cited by 10 publications

(7 citation statements)

References 31 publications

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“…Sanwick et al [4] expanded the preoperative biopsy criteria by including moderategrade unilateral tumours of patients having at least three biopsy cores on the noncancerous side. The same authors however reported that no safe parameters for considering nerve-sparing surgery were observed in patients with high-grade tumours, in any specimen with cancer present on biopsy, a finding which is in accordance with later observations [5] . Therefore, we feel that the patient selection based on histological differentiation criteria in order to perform NSRP is probably not safe because of the multifocality and heterogeneity of prostate cancer [6] .…”

supporting

confidence: 78%

Is the Presence of Perineural and Perivascular Invasion a Risk Factor for Positive Surgical Margins during Neurovascular Bundle Preservation Radical Prostatectomy Procedure?

Stamatiou¹,

Sofras²

2007

Urol Int

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supporting

confidence: 78%

Is the Presence of Perineural and Perivascular Invasion a Risk Factor for Positive Surgical Margins during Neurovascular Bundle Preservation Radical Prostatectomy Procedure?

Stamatiou¹,

Sofras²

2007

Urol Int

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“…Connolly et al. [6] attempted to use prostate biopsy data to predict the suitability for nerve‐sparing RP. In their series, 85% of men with unilateral disease on biopsy had pathological bilateral cancer.…”

Section: Discussionmentioning

confidence: 99%

Can contemporary transrectal prostate biopsy accurately select candidates for hemi‐ablative focal therapy of prostate cancer?

et al. 2009

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invasion (PNI), prostate volume, number of positive cores, and percentage of positive cores. Final surgical pathology was evaluated for unilateral cancer. Univariate analysis was used (logistic regression method) to identify independent predictors of unilateral disease on the RP specimen. A subset analysis was done in men with low-risk disease, defined as clinical stage T1C, Gleason score < 7 and a PSA level of < 10 ng/mL. RESULTSOf 590 men with unilateral disease on biopsy, 163 (27.3%) had unilateral disease on the RP specimen. Pathological features, including HGPIN ( P = 0.714), Gleason score ( P > 0.608), PNI ( P = 0.714), number of positive cores ( P = 0.076), percentage of cores positive ( P = 0.056), prostate volume ( P = 0.285), and PSA level ( P = 0.062) did not improve the prediction of unilateral disease.When men with unilateral cancer were further stratified to include only those with low-risk disease, 28.4% had unilateral disease on the RP specimen. None of the biopsy or clinical features evaluated were predictors of unilateral disease on the RP specimen.

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“…Studies have revealed that up to 74% of prostatectomy specimens with unilaterally positive biopsies have tumor in the contralateral side, with PSMs rates on the biopsy-shown ‘benign’ side from 24–31%. 13,14 Despite these concerns, single-institution studies have not shown NS RP to be an independent risk factor for PSMs or biochemical recurrence. 15–18 …”

Section: Discussionmentioning

confidence: 99%

Impact of nerve sparing on surgical margins and biochemical recurrence: results from the SEARCH database

Nelles

Freedland

Presti

et al. 2008

Prostate Cancer Prostatic Dis

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The effects of nerve sparing on the risk of positive surgical margins (PSMs) and biochemical recurrence after radical prostatectomy (RP) remain controversial. We examined data from 1018 men treated by RP between 1988 and 2006 at five centers in the Shared Equal Access Regional Cancer Hospital database. Neither bilateral nor unilateral nerve-sparing techniques were associated with a higher risk of PSM; on multivariate analysis of individual sides, the risk of PSM on either side was not increased by nerve sparing on either side. The risk for biochemical recurrence was not affected by bilateral or unilateral nerve sparing. When used on appropriately selected patients, nerve sparing does not increase the probability of PSM or biochemical recurrence after RP.

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Can prostate biopsies predict suitability for nerve‐sparing radical prostatectomy?

Abstract: Biopsy-suggested "unilateral" carcinoma was associated with both a high incidence of "bilateral" disease on final histology following radical prostatectomy and an alarming incidence (24%) of positive surgical margins on the "benign" side where NSRP might be advocated.

Cited by 10 publications

References 31 publications

Is the Presence of Perineural and Perivascular Invasion a Risk Factor for Positive Surgical Margins during Neurovascular Bundle Preservation Radical Prostatectomy Procedure?

Is the Presence of Perineural and Perivascular Invasion a Risk Factor for Positive Surgical Margins during Neurovascular Bundle Preservation Radical Prostatectomy Procedure?

Can contemporary transrectal prostate biopsy accurately select candidates for hemi‐ablative focal therapy of prostate cancer?

Impact of nerve sparing on surgical margins and biochemical recurrence: results from the SEARCH database

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