Estimation of prostate cancer volume by multiple core biopsies before radical prostatectomy

Egevad, Lars; Norberg, M.; Mattson, S.; Norlén, Bo Johan; Busch, Christer

doi:10.1016/s0090-4295(98)00221-0

Cited by 37 publications

(19 citation statements)

References 33 publications

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“…The overall Prior transurethral resection 39,46 Slides unavailable for review 28,39,42 Incomplete data on Clinical stage 37,46 Preoperative PSA value 37,46 Biopsy cancer volume 15,32,41,46 No. of biopsies taken 29,35 Clinical follow-up 11 risk was estimated at 17.6% (Fig. 3).…”

Section: Findings In the Radical Prostatectomy Specimenmentioning

confidence: 99%

The clinical management of patients with a small volume of prostatic cancer on biopsy: What are the risks of progression?

Harnden

Naylor

Shelley

et al. 2008

Cancer

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Clinically localized prostate cancer is associated with a wide variation in biologic behavior, and men with the less aggressive form of the disease may never develop symptoms. There has been a rise in prostate cancer incidence in countries in which the blood test for prostatic-specific antigen (PSA) is common, and concerns have been expressed that this may be because of the increased detection of indolent disease, subjecting these men to unnecessary treatment and associated side effects. For the current review, the authors conducted a systematic evaluation of the literature regarding the outcomes of men who were diagnosed on the basis of a small volume of cancer in prostatic biopsies. The results indicated that, despite differences in study design and reporting, a significant proportion of patients with microfocal cancer, regardless of how it was defined, had adverse pathologic findings and a significant risk of PSA recurrence after undergoing radical prostatectomy. Biochemical and clinical recurrences also were observed after radiotherapy or watchful waiting. The authors concluded that patients with microfocal carcinoma on biopsy should be advised that their disease is not necessarily ''insignificant'' and should be counseled accordingly. Cancer 2008; 112:971-81.

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Section: Findings In the Radical Prostatectomy Specimenmentioning

confidence: 99%

The clinical management of patients with a small volume of prostatic cancer on biopsy: What are the risks of progression?

Harnden

Naylor

Shelley

et al. 2008

Cancer

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“…Studies (1)(2)(3)(4) have shown that pathologic tumor volume correlates with pathologic stage, pathologic Gleason grade, margin status, and disease progression after radical prostatectomy. Tumors smaller than about 0.5 cm 3 and with no Gleason pattern 4 or 5 cancer are considered to be clinically insignificant and potentially appropriate for deferred therapy (5). McNeal et al (6) found that capsule penetration, seminal vesicle invasion, and positive surgical margins all correlated strongly with cancer volume.…”

Section: Discussionmentioning

confidence: 99%

Prostate Tumor Volume Measurement with Combined T2-weighted Imaging and Diffusion-weighted MR: Correlation with Pathologic Tumor Volume

Mazaheri¹,

Hricak²,

Fine³

et al. 2009

Radiology

190

130

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Purpose:To retrospectively determine the accuracy of diffusionweighted (DW) magnetic resonance (MR) imaging for identifying cancer in the prostate peripheral zone (PZ) and to assess the accuracy of tumor volume measurements made with T2-weighted imaging and combined T2-weighted and DW MR imaging by using surgical pathologic examination as the reference standard. Materials and Methods:The institutional review board issued a waiver of informed consent for this HIPAA-compliant study. Forty-two patients underwent endorectal MR at 1.5 T before undergoing radical prostatectomy for prostate cancer and had at least one PZ tumor larger than 0.1 cm 3 at surgical pathologic examination. On T2-weighted images, an experienced radiologist outlined suspected PZ tumors. Two apparent diffusion coefficient (ADC) cutoff values were identified by using the Youden index and published literature. Image cluster analysis was performed on voxels within the suspected tumor regions. Associations between volume measurements from imaging and from pathologic examination were assessed by using concordance correlation coefficients (CCCs). The sensitivity and specificity of ADCs for identifying malignant PZ voxels were calculated. Results:In identifying malignant voxels, respective ADC cutoff values of 0.0014 and 0.0016 mm 2 /sec yielded sensitivity of 82% and 95% and specificity of 85% and 65%, respectively. Sixty PZ cancer lesions larger than 0.1 cm 3 were found at pathologic examination; 43 were detected by the radiologist. CCCs between imaging and pathologic tumor volume measurements were 0.36 for T2-weighted imaging, and 0.46 and 0.60 for combined T2-weighted and DW MR imaging with ADC cutoffs of 0.0014 and 0.0016 mm 2 / sec, respectively; the CCC of combined T2-weighted and DW MR imaging (ADC cutoff, 0.0016 mm 2 /sec) was significantly higher (P ϭ .006) than that of T2-weighted imaging alone. Conclusion:Adding DW MR to T2-weighted imaging can significantly improve the accuracy of prostate PZ tumor volume measurement. RSNA, 2009 Supplemental Note: This copy is for your personal, non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, use the Radiology Reprints form at the end of this article.A ccurate noninvasive measurement of prostate cancer tumor volume could substantially improve the determination of tumor prognosis and assist in the selection of appropriate treatment. Studies (1-4) have shown that pathologic tumor volume correlates with pathologic stage, pathologic Gleason grade, margin status, and disease progression after radical prostatectomy. Tumors smaller than about 0.5 cm 3 and with no Gleason pattern 4 or 5 cancer are considered to be clinically insignificant and potentially appropriate for deferred therapy (5). McNeal et al (6) found that capsule penetration, seminal vesicle invasion, and positive surgical margins all correlated strongly with cancer volume. The latter study also showed that metastasis is highly likely when tumor volume is larger than 12 cm 3 , whereas ...

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“…However the exact value of this volume threshold is unknown and it may depend on other factors such are age, comorbidities and life expectancy. It seems that the best predictor for lesions < 1 cm 3 is a single focus < 3 mm with Gleason score < 7, provided an extended biopsy protocol has been used [37]. Also studies have shown that prostate volume is inversely related to prostate cancer volume and is a prognostic factor for minimal cancer [38].…”

Section: Clinical Management Of Single Foci Prostate Cancermentioning

confidence: 99%

Single Foci Prostate Cancer: Current Diagnosis and Management

Efthimiou¹,

Skrepetis²,

Bournia³

2013

Current Urology

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Diagnosis of small prostate cancer foci is a real challenge for pathologists and urologists as it carries the risk of false positive or negative diagnosis with clinical consequences. Diagnosis of small prostate cancer foci requires a strict methodological approach which includes a search for major and minor features under low and high magnification. Ambiguous cases can be further clarified with the use of basal cell immunomarkers complemented by a positive indicator of malignancy. Despite the new diagnostic armamentarium, a few cases will continue to remain doubtful and might require an appropriate rebiopsy.

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Estimation of prostate cancer volume by multiple core biopsies before radical prostatectomy

Cited by 37 publications

References 33 publications

The clinical management of patients with a small volume of prostatic cancer on biopsy: What are the risks of progression?

The clinical management of patients with a small volume of prostatic cancer on biopsy: What are the risks of progression?

Prostate Tumor Volume Measurement with Combined T2-weighted Imaging and Diffusion-weighted MR: Correlation with Pathologic Tumor Volume

Single Foci Prostate Cancer: Current Diagnosis and Management

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