Contemporary Role of Systematic Prostate Biopsies: Indications, Techniques, and Implications for Patient Care

Ukimura, Osamu; Coleman, Jonathan; Taille, A. De La; Emberton, Mark; Epstein, Jonathan I.; Freedland, Stephen J.; Giannarini, Gianluca; Kibel, Adam S.; Montironi, Rodolfo; Ploussard, Guillaume; Roobol, Monique J.; Scattoni, Vincenzo; Jones, J. Stephen

doi:10.1016/j.eururo.2012.09.033

Cited by 225 publications

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“…In a recent clinical study, MRI/ultrasound fusion guided biopsy resulted in an almost twofold increase in the rate of prostate cancer diagnosis in moderate and high risk patients, suggesting that traditional biopsy methods may miss up to 50% of prostate tumors [8]. Even when a tumor is sampled by the biopsy, the portion of the tumor obtained for histopathologic analysis may not be representative of the patient's disease, a fact reflected by the relatively common upgrading and upstaging of disease that occurs at the time of prostatectomy [9]. Therefore, even when prostate cancer is detected, there is a significant clinical need to improve the accuracy of characterizing the biological potential of the tumor.…”

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confidence: 99%

Metabolomic signatures of aggressive prostate cancer

et al. 2013

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BACKGROUND. Current diagnostic techniques have increased the detection of prostate cancer; however, these tools inadequately stratify patients to minimize mortality. Recent studies have identified a biochemical signature of prostate cancer metastasis, including increased sarcosine abundance. This study examined the association of tissue metabolites with other clinically significant findings. METHODS. A state of the art metabolomics platform analyzed prostatectomy tissues (331 prostate tumor, 178 cancer-free prostate tissues) from two independent sites. Biochemicals were analyzed by gas chromatography-mass spectrometry and ultrahigh performance liquid chromatography-tandem mass spectrometry. Statistical analyses identified metabolites associated with cancer aggressiveness: Gleason score, extracapsular extension, and seminal vesicle and lymph node involvement. RESULTS. Prostate tumors had significantly altered metabolite profiles compared to cancerfree prostate tissues, including biochemicals associated with cell growth, energetics, stress, and loss of prostate-specific biochemistry. Many metabolites were further associated with clinical findings of aggressive disease. Aggressiveness-associated metabolites stratified prostate tumor tissues with high abundances of compounds associated with normal prostate function (e.g., citrate and polyamines) from more clinically advanced prostate tumors. These aggressive prostate tumors were further subdivided by abundance profiles of metabolites including NADþ and kynurenine. When added to multiparametric nomograms, metabolites improved prediction of organ confinement (AUROC from 0.53 to 0.62) and 5-year recurrence (AUROC from 0.53 to 0.64). CONCLUSIONS. These findings support and extend earlier metabolomic studies in prostate cancer and studies where metabolic enzymes have been associated with carcinogenesis and/or outcome. Furthermore, these data suggest that panels of analytes may be valuable to translate metabolomic findings to clinically useful diagnostic tests. Prostate 73: [1547][1548][1549][1550][1551][1552][1553][1554][1555][1556][1557][1558][1559][1560] 2013. KEY WORDS:clinical heterogeneity; prostate cancer; metabolomics; diagnosis INTRODUCTIONProstate cancer is the most common male malignancy with an estimated 240,000 new cases and more than 28,000 deaths in the United States in 2012 [1]. Clinical detection of prostate cancer increased following the widespread adoption of serum prostate-specific antigen (PSA) screening; however, a significant fraction of prostate cancers detected solely on the basis of an increased serum PSA are indolent. As a result of concerns of over-diagnosis and over-treatment, a new paradigm of active surveillance in patient management has emerged recently [2]. The resulting broad spectrum of treatment options (none, focal therapy, radical surgery, or radiation) has been developed in response to the increased detection of low-risk prostate cancer [3]; however, the current panel of diagnostic tests provides limited information regarding the pr...

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Metabolomic signatures of aggressive prostate cancer

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“…Derivative parameters that have been proposed over the past decades have been disappointing, with the consequence that approximately 3 out of 4 men currently undergoing prostate biopsy (PB) do not have PCa, and are thus exposed to unnecessary and potentially morbid procedures [2].…”

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confidence: 99%

Clinical validation of the iXip index in avoiding unnecessary prostate biopsy: Results from a prospective multicenter study involving 426 patients

Gallotta¹,

Giannarini

Laurini³

et al. 2017

Cancer Treatment and Research Communications

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“…Dates from the literature state that despite of increasing the initial core numbers the gape I prostate cancer diagnosis remains about 30% [7]. Some studies describe up to 21 cores biopsy protocols, but this kind of extended protocols involve more complications [8], some of them important ones (haematospermia, haematuria, rectorrhagia, prostatitis, fever (>38C°), epididymitis, urinary retention [2,5]). Because of the post procedural potential complications, this invasive maneuver should be discussed with the patient, especially in cases when a rebiopsy is indicated.…”

Section: Discussionmentioning

confidence: 99%

“…There are some conditions which require even in the case of negative results a rebiopsy. Following the European Association of Urology Guideline (2014) the recommendations for repeat prostate biopsy are the rising or/and persistently elevated PSA, suspicious digital rectal examination, ASAP (Atypical small acinar proliferation), extensive HGPIN (prostatic intraepithelial neoplasia) [2,5]. With this retrospective study we would like to process and discuss our findings about the results of ultrasound guided prostate biopsies performed at the Clinic of Urology Târgu-Mureș, and correlate our results with the ones in the literature.…”

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confidence: 99%

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The Management of the Patient with Elevated Prostate Specific Antigen and a Negative Initial Prostate Biopsy

Vida

Szöllősi

Maier

et al. 2015

Acta Medica Marisiensis

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Background: The prostate cancer (PCa) is the second most common cancer amongst men. An elevated prostate specific antigen (PSA) level can lead to PCa suspition, thus the confirmation has to be a histopathological one. However, not all increased PSA level means prostate cancer. Material and Method: This retrospective study presents the results of 422 ultrasound guided prostate biopsy (PB) performed at the Clinic of Urology Târgu-Mureș, between 2011-2012. Inclusion criteria: patients with at least one negative PB and an elevated value of PSA. Results: In a two year period, from the total of 422 PB (100%), in 179 (42.42%) patients the histopathological result was "negative". In 154 (86%) of cases ultrasound guided biopsies were performed, mostly with an initial 6 core (98-54.74% of patients). Average PSA level was 13.45 ng/ml (0.49-100 ng/ml), the histological findings confirmed PCa in 52.58% cases, normal prostatic tissue in 141 cases (78.77%), atypical small acinar proliferation in 12 patients (6.70%), prostate atrophy in 11 males (6.14%), benign prostatic hyperplasia in 10 cases (5.59%) and prostatitis in 5 cases (2.80%). In 30 cases (16.75%) rebiopsy was performed with a number of 10-12 cores. Conclusions: In order to increase PCa detection we should perform more cores during PB. In "negative" histopathological cases PSA should be monitorised and the biopsy should be repeated after 6 to 8 weeks from the initial biopsy. Patient's compliance plays a vital role in the follow-up of the procedure. Introduction Despite the fact that prostate cancer is mostly a slow-growing cancer, still, thousands of men die of the disease each year and prostate cancer represents at the present moment the second most common cause of cancer death in males [1]. It is well-known that the incidence of prostate cancer increases with age and the highest rates are found in the seventh decade.The early and accurate detection of prostate cancer is critical for the appropriate management of the patients. In the detection of prostate cancer the first line of screening represents digital rectal examination and prostate specific antigen (PSA) determination [2][3][4][5][6][7]. Alone, the digital rectal examination has a low sensitivity and specificity in prostate cancer detection, having about 10% positive predictive value [1,4]. PSA is a kallikrein-like serine-protease, organ specific, produced almost exclusively by the epithelial cells of the prostate gland, it still remains the most used tumor marker for prostate cancer [2]. The standard PSA reference range in men's serum is 0,0-4,0 ng/ml [1]. The positive predictive value of digital rectal examination combined with determined serum PSA is about 30% in prostate cancer detection [1,2].Another useful diagnostic method in the prostate gland evaluation is the transrectal ultrasound of the prostate

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Contemporary Role of Systematic Prostate Biopsies: Indications, Techniques, and Implications for Patient Care

Cited by 225 publications

References 151 publications

Metabolomic signatures of aggressive prostate cancer

Metabolomic signatures of aggressive prostate cancer

Clinical validation of the iXip index in avoiding unnecessary prostate biopsy: Results from a prospective multicenter study involving 426 patients

The Management of the Patient with Elevated Prostate Specific Antigen and a Negative Initial Prostate Biopsy

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