Percentage of Cancer on Biopsy Cores Accurately Predicts Extracapsular Extension and Biochemical Relapse after Radical Prostatectomy for T1&amp;ndash;T2 Prostate Cancer

Ravery, V.; Chastang, Claude; Toublanc, M.; Boccon‐Gibod, Liliane; Delmas, V.; Boccon-Gibod, L

doi:10.1159/000020167

Cited by 71 publications

(55 citation statements)

References 33 publications

(37 reference statements)

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“…Another study has reported that preoperative PSA with a cutoff value of 17 ng/ml can predict organ confined disease with 90% sensitivity and 70% specificity (Ogawa et al, 1998). Similar results were found by another 2 studies reported that PSA is one of the most significant variables for ECD (Ravery et al, 2000;Ou et al, 2002). However, results from our case series have demonstrated that PSA was not a significant predictor for ECD and this was confirmed by multivariate analyses in the whole amount of studied patients and in patients of the 4 subgroups.…”

Section: Discussionsupporting

confidence: 60%

“…Mainly, the factors which are considered for analysis are the percentage of cancer in biopsy cores and the number or percentage of cores with cancer. More than 20% of cancer in biopsy material was highly correlated with ECD (Ou et al, 2002), while it has reported that the length of tissue core invaded by cancer is significant for ECD, as well (Ravery et al, 2000). Two recent nomograms have been proposed for prediction of ECD (Ohori et al, 2004;Satake et al, 2010).…”

Section: )mentioning

confidence: 99%

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Clinical and Pathological Parameters Predicting Extracapsular Disease in Patients Undergoing a Radical Prostatectomy for Clinically Localized Prostate Cancer

Sfoungaristos

Perimenis

2012

Prague Med. Rep.

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Section: Discussionsupporting

confidence: 60%

Section: )mentioning

confidence: 99%

Clinical and Pathological Parameters Predicting Extracapsular Disease in Patients Undergoing a Radical Prostatectomy for Clinically Localized Prostate Cancer

Sfoungaristos

Perimenis

2012

Prague Med. Rep.

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“…8,11 Others have questioned the usefulness of biopsy pathology findings in predicting the outcome of organ-confined prostate carcinoma on an individual basis. 10 According to a previous study conducted by the ERSPC, biopsy parameters may well be suitable for estimating the proportion of advanced malignancies in the context of a large, population-based study.…”

Section: Discussionmentioning

confidence: 99%

“…9 Other studies demonstrated a relation between extent of malignancy in the biopsy sample and pathologic stage in the prostatectomy specimen. 10,11 Thus, an arbitrary categorization model defining potentially advanced prostate carcinoma (PAC) on the basis of Gleason score and the amount of tumor present on sextant biopsy can be constructed. 6 Using such an arbitrary model, we considered detection during the second screening round of a significant number of cases of PAC (defined by a predominance of Gleason pattern 4 and/or 5 or by Ͼ 30% malignant involvement in samples with Gleason score 7 [3 ϩ 4]) on needle biopsy to be a possible indicator of the inadequacy of the current screening protocol.…”

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confidence: 99%

Potentially advanced malignancies detected by screening for prostate carcinoma after an interval of 4 years

Postma

Roobol

Schröder

et al. 2004

Cancer

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BACKGROUNDAt the Rotterdam branch of the European Randomized Study of Screening for Prostate Cancer, a cohort of 19,970 men ages 55–75 years is screened at an interval of 4 years. Screening includes systematic sextant needle biopsy for men with elevated prostate‐specific antigen (PSA) levels and/or positive findings on digital rectal examination or transrectal ultrasound. Detection during the second screening round of a large number of high‐grade (Gleason Grade 4 or 5) malignancies and/or a large number of malignancies in general could be considered the result of a failure to identify these malignancies at an early stage, during prevalence screening.METHODSMen diagnosed during the second screening round with potentially advanced carcinoma (PAC), characterized by a biopsy Gleason score of 7 (4 + 3, or 3 + 4 with > 30% malignant involvement) or a biopsy Gleason score of 8–10, were identified. Clinical data, including PSA values on prevalence screening, biopsy history, clinical stage, and follow‐up data, were retrieved for these patients. Tumor features were further analyzed in radical prostatectomy specimens.RESULTSDuring the second screening round, 503 malignancies, including 30 (6.0%) with features of PAC on diagnostic biopsy, were detected in 11,210 patients. Curative treatment was offered to 26 patients. Prostatectomy demonstrated the presence of organ‐confined disease in 11 of 12 specimens, and tumor volume ranged from 0.11–7.93 cm3 (median, 1.05 cm3). PSA failure was noted in 6 of 22 patients who were offered curative therapy.CONCLUSIONSPAC is a rare finding in the second round of screening after a 4‐year interval, and a substantial proportion of PAC cases detected in the second screening round represent organ‐confined disease. The findings of the current study suggest that the screening protocol used is sufficiently effective for detecting > 95% of malignancies before they develop features that would make them incurable. Cancer 2004;100:968–75. © 2004 American Cancer Society.

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“…Beyond cancer detection, biopsy results are also used to guide treatment selection. Gleason score, volume of tumour in the biopsy and perineural invasion have been to shown to be prognostic indicators of surgical stage and treatment success [7,8]. Compared with the many studies examining the benefit of more than six biopsy cores on cancer detection, little work has been done on the effect of the number of cores on the …”

Section: Introductionmentioning

confidence: 99%

The effect of sampling more cores on the predictive accuracy of pathological grade and tumour distribution in the prostate biopsy

Makhlouf¹,

Krupski²,

Kunkle³

et al. 2004

BJU International

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The technique for taking prostatic biopsies has received a major evaluation from many departments around the world in terms of the number of cores, site of biopsy, complications, need for local anaesthesia or sedation, etc., and the authors from Charlottesville review their technique. They present data confirming the impression that increasing the number of cores increases diagnostic sensitivity. Authors from Chapel Hill have performed a pilot study into the concept that cyclooxygenase (COX)‐2 inhibitors inhibit tumour growth in prostate cancer, both in vivo and in vitro. In a few patients they found evidence to suggest that COX‐2 inhibitors may be of value in patients with prostate cancer, concluding that a large trial is indicated. Vascular endothelial growth factor (VEGF) is known to be an important angiogenic factor. The authors from Sweden assessed its value as a marker in renal cancer cells. They found it to be present in most such cells, and found that the correlation between VEGF expression and tumour stage and prognosis was valuable in terms of progression of renal cancer. OBJECTIVE To determine if increasing the number of cores at biopsy improves the predictive accuracy of the Gleason score or aids in anticipating the location and volume of prostate tumour. PATIENTS AND METHODS The charts of 75 consecutive patients who underwent radical retropubic prostatectomy for clinical T1–2 adenocarcinoma of the prostate were reviewed retrospectively; 31 patients had a sextant biopsy (group 1) and 44 had ≥ 8 cores taken (group 2). The concordance between biopsy data and final prostatectomy Gleason score, tumour location and volume was determined for each group. RESULTS There were no differences in mean age, prostate‐specific antigen level before biopsy or biopsy Gleason score for the two groups; 58% of group 1 had their final pathological grade changed after prostatectomy, vs 29% of group 2 (P < 0.05). In neither group was there a significant correlation between the percentage of cores positive for tumour and the percentage volume of prostate involved with cancer, or the ability of the biopsy to predict tumour location. CONCLUSION Taking ≥ 8 biopsy cores improved the pathological grading accuracy, which may be valuable in choosing a treatment for the patient with newly diagnosed prostate cancer.

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Percentage of Cancer on Biopsy Cores Accurately Predicts Extracapsular Extension and Biochemical Relapse after Radical Prostatectomy for T1–T2 Prostate Cancer

Cited by 71 publications

References 33 publications

Clinical and Pathological Parameters Predicting Extracapsular Disease in Patients Undergoing a Radical Prostatectomy for Clinically Localized Prostate Cancer

Clinical and Pathological Parameters Predicting Extracapsular Disease in Patients Undergoing a Radical Prostatectomy for Clinically Localized Prostate Cancer

Potentially advanced malignancies detected by screening for prostate carcinoma after an interval of 4 years

The effect of sampling more cores on the predictive accuracy of pathological grade and tumour distribution in the prostate biopsy

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