Extraprostatic extension (pT3a) in prostate biopsy is an under-recognized feature indicating high risk disease

Tolonen, Teemu; Riikonen, Jarno; Tammela, Teuvo L.J.; Koivusalo, Laura; Haapasalo, Hannu; Kujala, Paula; Kaipia, Antti

doi:10.1016/j.anndiagpath.2018.06.001

Cited by 2 publications

(1 citation statement)

References 16 publications

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“…Furthermore, among the 12 RP specimens, eight (66.7%) showed multi-EPE locations that indicated extensive non-focal EPE, which was consistent with the higher non-focal EPE rate of 88% in a previous study by Fleshner et al [ 5 ]. Recently, Tolonen et al [ 26 ] and Chen et al [ 27 ] reported a higher biopsy incidence of EPE (4.9% [33/670] and 6.7% [117/1742], respectively) in their studies. Compared with our current study, the study cohort included a significantly higher percentage of patients with distant metastases (45.5% (15/33) and 59.8% (70/117), respectively), but much lower (12.5% (5/40)) in our cohort.…”

Section: Discussionmentioning

confidence: 99%

Detection of extraprostatic extension by transperineal multiparametric magnetic resonance imaging-ultrasound fusion targeted combined with systemic template prostate biopsy

Chuang,

Wu,

Lin

et al. 2023

Diagn Pathol

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Background Extraprostatic extension (EPE) of prostate cancer (PCa) on transrectal (TR) needle core biopsy (Bx) is a rare histopathological finding that can help in clinical decision-making. The detection efficiency of the transperineal (TP) approach is yet to be explored. Methods We retrospectively reviewed 2848 PCa cases using concomitant systemic template biopsy (SBx) and multiparametric magnetic resonance imaging (MRI)-ultrasound fusion-targeted biopsy (TBx) using the TR (n = 1917) or TP (n = 931) approach at our institution between January 2015 and July 2022. We assessed and compared clinical, MRI, and biopsy characteristics using different approaches (TP and TR) and methods (SBx and TBx). Results In total, 40 EPE cases were identified (40/2848, 1.4%). TP showed a significantly higher EPE detection rate compared to TR in SBx (TR:0.7% vs. TP:1.6%; p = 0.028) and TBx (TR:0.5% vs. TP:1.2%; p = 0.033), as well as the combined methods (2.1% vs. 1.1%, p = 0.019). A significantly higher incidence of EPEs was found at non-base sites in TP than in TR (76.7% vs. 50%, p = 0.038). SBx showed a higher EPE detection rate than TBx; however, the difference was not statistically significant. TP showed higher prostate-specific antigen density (0.35 vs. 0.17, p = 0.005), higher frequency of GG4-5 in the cores with EPE (65.0% vs. 50.0%, p = 0.020), and more PCa-positive SBx cores (10 vs. 8, p = 0.023) compared to the TR. Conclusions TP may improve EPE detection compared with TR and should be applied to patients with adverse pre-biopsy features.

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Section: Discussionmentioning

confidence: 99%