Spatial Distribution of Prostate Cancers Undetected on Initial Needle Biopsies

Diffusion-weighted magnetic resonance imaging in prostate cancer patients on active surveillance one year after diagnosis and before repeat biopsy

“…The other predictive factors (PSA, free PSA, Gleason score, number of positive biopsies) were available at enrolment. The rationale to conduct MRI before 1 year repeat biopsy was based on the fact that transrectal biopsies miss a significant part of, in particular, apical tumours [20][21][22]. The aim of the present study was to use MRI to rule out these tumours in patients on AS.…”

Clinicopathological features of prostate cancer in Japanese men diagnosed on repeat transrectal ultrasound-guided biopsy

“…Furthermore, to our knowledge, there have been few studies analyzing the pathological data of radical prostatectomy specimens obtained from patients diagnosed after an initial negative biopsy. [13][14][15][16] Considering these findings, more data are necessary to characterize the clinicopathological features of prostate cancer detected after false-negative biopsy findings.…”

“…These findings are supported by several previous studies. 7,[13][14][15][16] Furthermore, it has recently been shown that the majority of tumors found using an extensive repeat biopsy technique were clinically significant. 10,11 For example, Borboroglu et al 10 reported that extensive repeat biopsy sampling of an average of 22.5 cores in patients with previous benign sextant biopsies resulted in the detection of pathologically significant disease in most cases.…”

“…In this series, false-negative biopsy findings may have been due to a small tumor focus occurring in a large prostate. Mazal et al 14 performed detailed analysis of the spatial distribution of prostate cancers that were not detected on initial biopsies, and advocated an early repeat biopsy, with special emphasis on the apico-dorsal PZ, where cancer foci were frequently located in radical prostatectomy specimens with negative initial biopsies. We also found a similar tendency in disease location, despite a lack of statistical significance (data not shown); therefore, we currently take samples from the bilateral apico-dorsal PZ in addition to the previously described eight cores.…”

“…However, to our knowledge, there have been a few studies analyzing the characteristics of prostate cancers detected on repeat biopsy. [13][14][15][16] Therefore, we retrospectively evaluated, in Japanese men who subsequently underwent radical prostatectomy, the clinicopathological features of prostate cancers diagnosed on repeat biopsy in comparison with those detected on initial biopsy.…”