Correlation between prostate needle biopsies and radical prostatectomy specimens can we predict pathological outcome?

Zam, Nor Azhari Bin Mohd; Tan, Puay Hoon; Sim, Hong Gee; Lau, Weber; Yip, Sze Fai; Cheng, Christopher

doi:10.1080/00313020802320671

Cited by 17 publications

(14 citation statements)

References 30 publications

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“…This difference was significantly higher in patients with extraprostatic disease and positive seminal vesicles (pT3) (14,21,26) in comparison with patients with organ-confined disease (pT2), revealing a strong association between tumor involvement on biopsy and pathologic staging. D'Amico et al (5) observed that the percentage of positive fragments in biopsy is an important parameter to predict intraprostatic disease, showing that, when less that 34% of fragments are affected, 79% of patients have disease confined to the gland, and when the number of affected fragments is higher than 50%, only 43% have the confined disease.…”

Section: Discussionmentioning

confidence: 91%

“…PAF in the prostate biopsy has been accepted as the most easily reproducible parameter, since it takes little time from the pathologist and may standardize the different biopsy strategies (1,6,25,26) ; in several articles it has been considered an excellent predictor of poor results after RP (4,7,9,16,21) . In a recent study, Quintal et al (19) evaluated these several methods to predict extraprostatic disease and identified that the maximum length or percentage of cancer in a single fragment was not significant: the total percentage of cancer in the biopsy was the method with the strongest predictive value.…”

Section: Discussionmentioning

confidence: 99%

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The percentage of affected fragments in needle biopsy in the assessment of pathological staging of prostate cancer

Andrade¹,

Lucena²,

Braga³

et al. 2013

J. Bras. Patol. Med. Lab.

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Introduction: Prostate cancer has high prevalence and mortality among men. Some of the findings on prostate biopsy may be related to the prognosis of the disease. Objective: To evaluate the association between the percentage of fragments affected by cancer in the prostate biopsy and the pathological staging in the surgical specimen. Materials and methods: Selected 159 patients underwent radical prostatectomy (RP) between 2003 and 2009. Data was collected on age, digital rectal exam, prostate-specific antigen (PSA), Gleason score, number of biopsy fragments, number of fragments affected by tumor, and tumor extension in the surgical specimen. Statistical analysis with Student's t-test, chi-squared test, and multiple logistic regression evaluated the association of percentage of affected fragments (PAF) with tumor extension and its predictive value. Results: The patients mean age and PSA were respectively 64 years and 8.5 ng/ml. Histopathologic evaluation of surgical specimens revealed 20.8% of patients with extraprostatic disease, 8.2% with seminal vesicle invasion and 35.8% with positive margins. We found that patients with extraprostatic disease, positive surgical margins, and seminal vesicle invasion had a higher mean PAF. PAF was divided into three groups: less than 34%, 34% to 50%, and greater than 50%, and the higher the PFA, the larger the increase in pathological changes. Conclusion: PAF in biopsy is a simple and practical parameter, which should be used as a predictor of pathological stage in RP specimen.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

The percentage of affected fragments in needle biopsy in the assessment of pathological staging of prostate cancer

Andrade¹,

Lucena²,

Braga³

et al. 2013

J. Bras. Patol. Med. Lab.

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“…7,9,[20][21][22] Compared with the correlation provided by sampling techniques that collected few samples, the sampling protocol used in this study, 12-core TRUS, allowed better correlation between the number and percentage of positive biopsy cores and pathologic tumor stage. 8 A historical factor that confounds this comparison is the temporal sequence in which the 12-core TRUS was introduced after PSA screening while the older 6-core TRUS had been introduced in the pre-PSA screening era.…”

Section: Discussionmentioning

confidence: 99%

“…These specific connections add detail and precision to the strong fundamental association between the number of positive cores and tumor volume at radical prostatectomy. 8,9,[20][21][22] In particular, the number of positive cores and the maximum and average biopsy core percentage predict pathologic stage and tumor volume at radical prostatectomy. In relation to the correlation between percentage of tumor at biopsy cores with tumor volume at prostatectomy, we demonstrated a significant inverse predictive relationship between the CV of core tumor percentage and tumor volume at radical prostatectomy.…”

Section: Discussionmentioning

confidence: 99%

Findings in 12-Core Transrectal Ultrasound-Guided Prostate Needle Biopsy That Predict More Advanced Cancer at Prostatectomy

et al. 2012

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We analyzed 5 features on 12-core transrectal ultrasound-guided prostate needle biopsy (TRUS) to predict the extent of cancer at radical prostatectomy (RP). In 388 TRUS-RP pairs, number of positive cores (NPC), percentage of each core involved (%PC), perineural invasion (PNI), Gleason score (GS), distribution of positive cores (DPC), and preoperative prostate-specific antigen (PSA) were correlated with extraprostatic extension (EPE), seminal vesicle invasion (SVI), positive surgical margin (R1), positive lymph nodes (N1), and tumor volume. All features predicted EPE and SVI. NPC, GS, %PC, and PNI strongly predicted R1 status. RP tumor volume was directly proportional to the NPC and %PC. PSA alone and with selected biopsy findings correlated with tumor volume, stage, SVI, and N1 (P < .0001). Contiguous DPC was a significant risk for EPE and SVI (P < .0001) compared with isolated positive cores. Findings at 12-core TRUS along with preoperative PSA reliably predict advanced local disease and have practical value as guides to effective planning for surgical resections.

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“…However, these treatments are usually advocated for selected low risk unifocal prostate cancers and their choice are heavily reliant on the biopsy Gleason score. However, undergrading of these biopsy samples occurs in 20–30% of cases and may be minimized with better molecular interrogation techniques such as a methylation signature like PHYMA [43].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and Prognostic Utility of a DNA Hypermethylated Gene Signature in Prostate Cancer

et al. 2014

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We aimed to identify a prostate cancer DNA hypermethylation microarray signature (denoted as PHYMA) that differentiates prostate cancer from benign prostate hyperplasia (BPH), high from low-grade and lethal from non-lethal cancers. This is a non-randomized retrospective study in 111 local Asian men (87 prostate cancers and 24 BPH) treated from 1995 to 2009 in our institution. Archival prostate epithelia were laser-capture microdissected and genomic DNA extracted and bisulfite-converted. Samples were profiled using Illumina GoldenGate Methylation microarray, with raw data processed by GenomeStudio. A classification model was generated using support vector machine, consisting of a 55-probe DNA methylation signature of 46 genes. The model was independently validated on an internal testing dataset which yielded cancer detection sensitivity and specificity of 95.3% and 100% respectively, with overall accuracy of 96.4%. Second validation on another independent western cohort yielded 89.8% sensitivity and 66.7% specificity, with overall accuracy of 88.7%. A PHYMA score was developed for each sample based on the state of methylation in the PHYMA signature. Increasing PHYMA score was significantly associated with higher Gleason score and Gleason primary grade. Men with higher PHYMA scores have poorer survival on univariate (p = 0.0038, HR = 3.89) and multivariate analyses when controlled for (i) clinical stage (p = 0.055, HR = 2.57), and (ii) clinical stage and Gleason score (p = 0.043, HR = 2.61). We further performed bisulfite genomic sequencing on 2 relatively unknown genes to demonstrate robustness of the assay results. PHYMA is thus a signature with high sensitivity and specificity for discriminating tumors from BPH, and has a potential role in early detection and in predicting survival.

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Correlation between prostate needle biopsies and radical prostatectomy specimens can we predict pathological outcome?

Cited by 17 publications

References 30 publications

The percentage of affected fragments in needle biopsy in the assessment of pathological staging of prostate cancer

The percentage of affected fragments in needle biopsy in the assessment of pathological staging of prostate cancer

Findings in 12-Core Transrectal Ultrasound-Guided Prostate Needle Biopsy That Predict More Advanced Cancer at Prostatectomy

Diagnostic and Prognostic Utility of a DNA Hypermethylated Gene Signature in Prostate Cancer

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