Comparing Image-guided targeted Biopsies to Radical Prostatectomy Specimens for Accurate Characterization of the Index Tumor in Prostate Cancer

Porpiglia, Francesco; Luca, Stefano De; Checcucci, Enrico; Garrou, D.; Manfredi, Matteo; Mele, F.; Pecoraro, Angela; Passera, Roberto; Bollito, Enrico; Fiori, Cristian

doi:10.21873/anticanres.12560

Cited by 3 publications

(2 citation statements)

References 25 publications

(42 reference statements)

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“…Francesco et al reported it as 82.2% (n = 152) [5,33]. In this study, which used bpMRI-TRUS fusion biopsy, the accuracy of IT assessment was 85.5% (59/69), which we considered to be comparable to previous mpMRI reports.…”

Section: Discussionsupporting

confidence: 80%

Assessment of the Accuracy of Biparametric MRI/TRUS Fusion-Guided Biopsy for Index Tumor Evaluation using Postoperative Pathology Specimens

Shimizu

Morizane

Yamamoto

et al. 2023

Preprint

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Background Multiparametric MRI (mpMRI) is widely used for prostate cancer diagnosis, surveillance, and staging; however, it has some limitations, including higher cost, longer examination time, and the use of gadolinium-based contrast agents. This study aimed to investigate the accuracy of index tumor (IT) assessed preoperatively using biparametric MRI (bpMRI)/transrectal ultrasound (TRUS) fusion prostate biopsy with radical prostatectomy (RP) specimens. Methods We included 69 patients diagnosed with prostate cancer through bpMRI/TRUS fusion-guided biopsy of lesions with Prostate Imaging Reporting & Data System (PI-RADS) category ≥ 3 and underwent robot-assisted laparoscopic radical prostatectomy (RARP) at our institution between July 2017 and December 2021. The localization of preoperative and postoperative IT, highest Gleason score (GS), and tumor diameter were examined in these patients. Results The preoperative cT stage matched the postoperative pT stage in 34 cases (48%), while 20 cases (30%) were upstaged, and 15 cases (22%) were downstaged (Weighted Kappa = 0.236). The preoperative and postoperative IT localization were consistent in 59 cases (85.5%). The concordance rate between Gleason groups in targeted biopsy and RP specimens was 48%, with an upgrade in 17 cases (24%) and a downgrade in 29 cases (28%) (Weighted Kappa = 0.424). The IT maximum diameter and maximum cancer core length on biopsy were correlated with RP tumor maximum diameter (p = 0.007, p = 0.008). Conclusion In conclusion, the diagnostic accuracy of bpMRI/TRUS fusion biopsy is comparable to that of previous reports using mpMRI. The findings suggest that bpMRI/TRUS fusion biopsy can be a cost-effective and time-saving alternative.

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Section: Discussionsupporting

confidence: 80%

Assessment of the Accuracy of Biparametric MRI/TRUS Fusion-Guided Biopsy for Index Tumor Evaluation using Postoperative Pathology Specimens

Shimizu

Morizane

Yamamoto

et al. 2023

Preprint

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“…Furthermore, if an index tumor in the central zone is suggested during preoperative evaluation, a multimodal treatment combining neoadjuvant hormonal therapy and/or chemotherapy with radical prostatectomy may be required. Recently, index tumors have been evaluated preoperatively using radiological and biopsy approach [ 24 , 25 ]. Our results may allow urologists and patients to reconsider the therapeutic strategies for prostate cancer.…”

Section: Discussionmentioning

confidence: 99%

Index tumor location affected early biochemical recurrence after radical prostatectomy in patients with negative surgical margin: a retrospective study

Ogata,

Akatsuka,

Endo

et al. 2024

BMC Urol

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Background Index tumors are the most aggressive tumors of the prostate. However, their clinical significance remains unclear. This study aimed to assess the incidence of index tumor location according to the zonal origin and whether these locations affect the prognosis after radical prostatectomy in patients with negative surgical margins. Methods This single-centered, retrospective study evaluated 1,109 consecutive patients who underwent radical prostatectomies. An index tumor was defined as the largest tumor in the prostate gland. We detected these locations based on McNeal's zonal origin using whole-mount sections. Biochemical recurrence (BCR) free survival curves were generated using the Kaplan–Meier method. Univariate and multivariate analyses using the Cox proportional hazards model were performed to determine the predictive factors for early BCR (within 1-year). Results A total of 621 patients with negative surgical margins who did not receive adjuvant therapy were included in this study. The index tumor were located in the transitional zone in 191 patients (30.8%), the peripheral zone in 399 patients (64.3%), and the central zone in 31 patients (5.0%). In total, 22 of 621 patients (3.5%) experienced early BCR and 70 patients (11.2%) experienced overall BCR at a median follow-up of 61.7 months. According to the index tumor location, the early BCR-free rates were 99.5%, 95.7 %, and 83.3% in the transitional, peripheral, and central zones, respectively. On multivariate analysis, the index tumor in the central zone was an independent predictor of early BCR with negative surgical margins following radical prostatectomy, followed by prostatectomy pathological grade, index tumor in the peripheral zone, and high prostate-specific antigen level. Conclusions We assessed the significance of index tumor location in patients with negative surgical margins following radical prostatectomy. Index tumors located in the central zone, although infrequent, were the strongest predictive factors for early BCR. Our results may allow urologists and patients to reconsider the therapeutic strategies for prostate cancer.

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MRI-guided in-bore biopsy for prostate cancer: what does the evidence say? A case series of 554 patients and a review of the current literature

et al. 2018

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Comparing Image-guided targeted Biopsies to Radical Prostatectomy Specimens for Accurate Characterization of the Index Tumor in Prostate Cancer

Abstract: TBx has a high sensitivity for characterization of index lesions, with a good concordance for topographic and Gleason grading accuracy between biopsy and surgical specimens.

Cited by 3 publications

References 25 publications

Assessment of the Accuracy of Biparametric MRI/TRUS Fusion-Guided Biopsy for Index Tumor Evaluation using Postoperative Pathology Specimens

Assessment of the Accuracy of Biparametric MRI/TRUS Fusion-Guided Biopsy for Index Tumor Evaluation using Postoperative Pathology Specimens

Index tumor location affected early biochemical recurrence after radical prostatectomy in patients with negative surgical margin: a retrospective study

MRI-guided in-bore biopsy for prostate cancer: what does the evidence say? A case series of 554 patients and a review of the current literature

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