What Is the Ideal Core Number for Ultrasound-Guided Prostate Biopsy?

Chambó, Renato Caretta; Tsuji, Fábio Hissachi; Lima, Flávio de Oliveira; Yamamoto, Hamilto Akihissa; Jesus, Carlos Márcio Nóbrega de

doi:10.4111/kju.2014.55.11.725

Cited by 7 publications

(7 citation statements)

References 29 publications

(40 reference statements)

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“…En una revisión sistemática donde se analizaron 87 estudios con un total de 20,698 pacientes, se encontró que las biopsias que toman 12 cilindros representan el equilibrio entre la detección del cáncer y los eventos adversos y que la toma de más de 12 muestras no genera un beneficio significativo. 33,34 Se encontró una asociación estadísticamente significativa entre el porcentaje de compromiso tumoral en biopsias y el valor de PSA, hallazgo similar a lo descrito por Bang Shim y cols. 35 Dentro de los hallazgos de este estudio, se pudo evidenciar dificultad al momento de la obtención de la información debido a un registro incompleto en las historias clínicas de algunas variables como porcentaje de volumen tumoral, diagnóstico clínico, examen digital rectal, volumen por ecografía, puntaje de Gleason e Invasión capsular.…”

Section: Discussionunclassified

Presentación clínico-patológica del adenocarcinoma prostático en un Hospital de tercer nivel en Colombia

Lecompte-Osorio

Lázaro

Benedetti

2019

Revista Urología Colombiana / Colombian Urology Journal

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Introducción y objetivo Mundialmente, el cáncer de próstata es la segunda neoplasia maligna más frecuente en hombres a nivel mundial y la primera en Colombia. Se determinaron las características clínico-patológicas de los casos de cáncer de próstata diagnosticados en un hospital de la región caribe colombiana. Materiales y Métodos Se realizó un estudio retrospectivo en la Facultad de Medicina de la Universidad de Cartagena, Colombia. Se analizaron las características clínicas y patológicas de todos los pacientes diagnosticados con cáncer de próstata en el Hospital Universitario del Caribe durante los años 2007 a 2014. Resultados Se documentaron 394 casos, con edad promedio de 71,13 años (DE ± 8,25). El puntaje de Gleason fue mayor o igual a 8 en el 31,7%. En biopsias hubo localización bilateral del tumor en un 73,5% y compromiso tumoral mayor al 40% del tejido en el 73,2% de los casos. En un 5,8% de los pacientes, hubo valores de PSA normales. Se dio una asociación estadísticamente significativa entre el PSA y el examen digital rectal (p = 0,0009), puntaje de Gleason (p < 0,0001) y porcentaje de compromiso tumoral en biopsias (p < 0,0012). La combinación PSA más examen digital rectal obtuvo una sensibilidad del 96%. Conclusiones Gran parte de los casos de cáncer de próstata se diagnostican en estadios avanzados. La mayor sensibilidad para el diagnóstico clínico la tiene el uso del PSA más el examen digital rectal, sin dejar de lado la experiencia clínica que permite diagnosticarlo aún con PSA o examen digital rectal normales. Esos hallazgos deben promover la educación de la población.

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Section: Discussionunclassified

Presentación clínico-patológica del adenocarcinoma prostático en un Hospital de tercer nivel en Colombia

Lecompte-Osorio

Lázaro

Benedetti

2019

Revista Urología Colombiana / Colombian Urology Journal

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“…The question remains as to what the optimal number of biopsy cores should be. The study by Chambo et al [ 13 ] showed that at least 10-core biopsies may be needed in patients with low-risk prostate cancer. Adopting this concept, the present study recruited only patients who underwent biopsies of more than 10 cores.…”

Section: Discussionmentioning

confidence: 99%

Pathological upgrading in prostate cancer patients eligible for active surveillance: Does prostate-specific antigen density matter?

et al. 2015

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PurposeTo evaluate prospectively the role of prostate-specific antigen (PSA) density in predicting Gleason score upgrading in prostate cancer patients eligible for active surveillance (T1/T2, biopsy Gleason score≤6, PSA≤10 ng/mL, and ≤2 positive biopsy cores).Materials and MethodsBetween January 2010 and November 2013, among patients who underwent greater than 10-core transrectal ultrasound-guided biopsy, 60 patients eligible for active surveillance underwent radical prostatectomy. By use of the modified Gleason criteria, the tumor grade of the surgical specimens was examined and compared with the biopsy results.ResultsTumor upgrading occurred in 24 patients (40.0%). Extracapsular disease and positive surgical margins were found in 6 patients (10.0%) and 8 patients (17.30%), respectively. A statistically significant correlation between PSA density and postoperative upgrading was found (p=0.030); this was in contrast with the other studied parameters, which failed to reach significance, including PSA, prostate volume, number of biopsy cores, and number of positive cores. Tumor upgrading was also highly associated with extracapsular cancer extension (p=0.000). The estimated optimal cutoff value of PSA density was 0.13 ng/mL2, obtained by receiver operating characteristic analysis (area under the curve=0.66; p=0.020; 95% confidence interval, 0.53-0.78).ConclusionsPSA density is a strong predictor of Gleason score upgrading after radical prostatectomy in patients eligible for active surveillance. Because tumor upgrading increases the potential for postoperative pathological adverse findings and prognosis, PSA density should be considered when treating and consulting patients eligible for active surveillance.

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“…A definitive diagnosis of cancer depends on the histopathological analysis of a core needle biopsy sample. In one prospective study, the negative rate of a 12-core biopsy technique was found to be more than 30% [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Two-dimensional neovascular complexity is significantly higher in nontumor prostate tissue than in low-risk prostate cancer

Taverna

Grizzi²,

Colombo

et al. 2015

Korean J Urol

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PurposeProstate cancer is the most frequent cancer in men in Europe. A major focus in urology is the identification of new biomarkers with improved accuracy in patients with low-risk prostate cancer. Here, we evaluated two-dimensional neovascular complexity in prostate tumor and nontumor biopsy cores by use of a computer-aided image analysis system and assessed the correlations between the results and selected clinical and pathological parameters of prostate carcinoma.Materials and MethodsA total of 280 prostate biopsy sections from a homogeneous series of 70 patients with low-risk prostate cancer (Gleason score 3+3, prostate-specific antigen [PSA]<10 ng/mL, and clinical stage T1c) who underwent systematic biopsy sampling and subsequent radical prostatectomy were analyzed. For each biopsy, 2-µm sections were treated with CD34 antibodies and were digitized by using an image analysis system that automatically estimates the surface fractal dimension.ResultsOur results showed that biopsy sections without cancer were significantly more vascularized than were tumors. No correlations were found between the vascular surface fractal dimension and patient's age, PSA and free-to-total PSA ratios, pathological stage, Gleason score, tumor volume, vascular invasion, capsular penetration, surgical margins, and biochemical recurrence.ConclusionsThe value of angiogenesis in prostate cancer is still controversial. Our findings suggest that low-risk prostate cancer tissues are less vascularized than are nontumor tissues. Further studies are necessary to understand whether angiogenesis is a hallmark of intermediate- and high-risk prostate cancer.

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What Is the Ideal Core Number for Ultrasound-Guided Prostate Biopsy?

Cited by 7 publications

References 29 publications

Presentación clínico-patológica del adenocarcinoma prostático en un Hospital de tercer nivel en Colombia

Presentación clínico-patológica del adenocarcinoma prostático en un Hospital de tercer nivel en Colombia

Pathological upgrading in prostate cancer patients eligible for active surveillance: Does prostate-specific antigen density matter?

Two-dimensional neovascular complexity is significantly higher in nontumor prostate tissue than in low-risk prostate cancer

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