nach oben

World Journal of Urology

Erschienen in:

01.04.2014 | Original Article

Incremental value of transition zone and midline apical biopsy at baseline TRUS-guided biopsy for prostate cancer detection

verfasst von: D. M. Somford, W. Vreuls, T. S. Jansen, J. P. van Basten, H. Vergunst

Erschienen in: World Journal of Urology | Ausgabe 2/2014

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To determine the diagnostic yield of transition zone (TZB) and midline apical biopsies (MAB) in baseline transrectal ultrasound (TRUS)-guided biopsies and to establish whether TZB and MAB for the diagnosis of prostate cancer (PCa) add clinical relevant information.

Methods

We performed baseline 9-core TRUS-guided biopsy in 412 consecutive subjects using sextant biopsies of the PZ (PZB), with an additional TZB on either side and a MAB at the prostatic apex. We determined the incremental diagnostic value of additional TZB an MAB to sextant PZB.

Results

Within a cohort of 412 patients with a median PSA of 7.5 ng/ml, 178 (43.2 %) patients were diagnosed with PCa upon baseline TRUS-guided biopsies. In 102 cases, at least one TZB was positive for PCa, with 6/412 (1.4 %) cases displaying PCa in the TZB only. MAB alone was positive for PCa in 4/412 (1.0 %) cases. One case (1/412; 0.2 %) had only a TZB and a MAB positive for PCa without positive PZB. Thus, 11/412 (2.7 %) of cases would not have been diagnosed with PCa at baseline TRUS-guided biopsy had only sextant PZ biopsy been performed. TZB detected a high-grade Gleason component (Gleason 4 and/or 5) not present in the PZB in 2.4 % of PCa cases.

Conclusions

There is limited value for TZB and MAB in the context of sextant PZB at baseline TRUS-guided biopsies for PCa.

Ukimura O, Coleman JA, de la Taille A et al (2013) Contemporary role of systematic prostate biopsies: indications, techniques, and implications for patient care. Eur Urol 63(2):214–230PubMedCrossRef

Chun FK, Epstein JI, Ficarra V et al (2010) Optimizing performance and interpretation of prostate biopsy: a critical analysis of the literature. Eur Urol 58(6):851–864PubMedCrossRef

Reissigl A, Pointner J, Strasser H et al (1997) Frequency and clinical significance of transition zone cancer in prostate cancer screening. Prostate 30(2):130–135PubMedCrossRef

Guichard G, Larré S, Gallina A et al (2007) Extended 21-sample needle biopsy protocol for diagnosis of prostate cancer in 1000 consecutive patients. Eur Urol 52(2):430–435PubMedCrossRef

Pelzer AE, Bektic J, Berger AP et al (2005) Are transition zone biopsies still necessary to improve prostate cancer detection? Results from the Tyrol screening project. Eur Urol 48(6):916–921PubMedCrossRef

King CR, Ferrari M, Brooks JD et al (2009) Prognostic significance of prostate cancer originating from the transition zone. Urol Oncol 27(6):592–597PubMedCrossRef

Sakai I, Harada K, Kurahashi T et al (2006) Analysis of differences in clinicopathological features between prostate cancers located in the transition and peripheral zones. Int J Urol 13(4):368–372PubMedCrossRef

Ouzaid I, Xylinas E, Campeggi A et al. (2011) Contemporary pathologic characteristics and oncologic outcomes of prostate cancers missed by 6- and 12-core biopsy and diagnosed with a 21-core biopsy protocol. World J Urol [Epub ahead of print]

Al-Ahmadie HA, Tickoo SK, Olgac S et al (2008) Anterior-predominant prostatic tumors: zone of origin and pathologic outcomes at radical prostatectomy. Am J Surg Pathol 32(2):229–235PubMedCrossRef

10.

Augustin H, Erbersdobler A, Graefen M et al (2003) Differences in biopsy features between prostate cancers located in the transition and peripheral zone. BJU Int 91(6):477–481PubMedCrossRef

11.

Davis JW, Kim J, Ward JF et al (2010) Radical prostatectomy findings in patients predicted to have low-volume/low-grade prostate cancer diagnosed by extended-core biopsies: an analysis of volume and zonal distribution of tumour foci. BJU Int 105(10):1386–1391PubMedCrossRef

12.

Soos G, Tsakiris I, Szanto J et al (2005) The prevalence of prostate carcinoma and its precursor in Hungary: an autopsy study. Eur Urol 48(5):739–744PubMedCrossRef

13.

Nevoux P, Ouzzane A, Ahmed HU et al (2012) Quantitative tissue analyses of prostate cancer foci in an unselected cystoprostatectomy series. BJU Int 110(4):517–523PubMedCrossRef

14.

Epstein JI, Allsbrook WC Jr, Amin MB et al (2005) ISUP Grading Committee. The 2005 international society of urological pathology (ISUP) consensus conference on gleason grading of prostatic carcinoma. Am J Surg Pathol 29(9):1228–1242PubMedCrossRef

15.

Fink KG, Hutarew G, Esterbauer B et al (2003) Evaluation of transition zone and lateral sextant biopsies for prostate cancer detection after initial sextant biopsy. Urology 61(4):748–753PubMedCrossRef

16.

Epstein JI, Walsh PC, Sauvageot J et al (1997) Use of repeat sextant and transition zone biopsies for assessing extent of prostate cancer. J Urol 158(5):1886–1890PubMedCrossRef

17.

Djavan B, Mazal P, Zlotta A et al (2001) Pathological features of prostate cancer detected on initial and repeat prostate biopsy: results of the prospective European prostate cancer detection study. Prostate 47(2):111–117PubMedCrossRef

18.

De la Rosette JJ, Wink MH, Mamoulakis C et al (2009) Optimizing prostate cancer detection: 8 versus 12-core biopsy protocol. J Urol 182(4):1329–1336PubMedCrossRef

19.

Dimmen M, Vlatkovic L, Hole KH et al (2012) Transperineal prostate biopsy detects significant cancer in patients with elevated prostate-specific antigen (PSA) levels and previous negative transrectal biopsies. BJU Int 110(2 Pt 2):E69–E75PubMedCrossRef

20.

Patel V, Merrick GS, Allen ZA et al (2011) The incidence of transition zone prostate cancer diagnosed by transperineal template-guided mapping biopsy: implications for treatment planning. Urology 77(5):1148–1152PubMedCrossRef

21.

Mabjeesh NJ, Lidawi G, Chen J et al (2012) High detection rate of significant prostate tumours in anterior zones using transperineal ultrasound-guided template saturation biopsy. BJU Int 110(7):993–997PubMedCrossRef

22.

Satoh T, Matsumoto K, Fujita T et al (2005) Cancer core distribution in patients diagnosed by extended transperineal prostate biopsy. Urology 66(1):114–118PubMedCrossRef

23.

Anastasiadis AG, Lichy MP, Nagele U et al (2006) MRI-guided biopsy of the prostate increases diagnostic performance in men with elevated or increasing PSA levels after previous negative TRUS biopsies. Eur Urol 50(4):738–748PubMedCrossRef

24.

Hambrock T, Somford DM, Hoeks C et al (2010) Magnetic resonance imaging guided prostate biopsy in men with repeat negative biopsies and increased prostate specific antigen. J Urol 183(2):520–527PubMedCrossRef

25.

Hoeks CM, Schouten MG, Bomers JG et al (2012) Three-Tesla magnetic resonance-guided prostate biopsy in men with increased prostate-specific antigen and repeated, negative, random, systematic, transrectal ultrasound biopsies: detection of clinically significant prostate cancers. Eur Urol 62(5):902–909PubMedCrossRef

26.

Roethke M, Anastasiadis AG, Lichy M et al (2012) MRI-guided prostate biopsy detects clinically significant cancer: analysis of a cohort of 100 patients after previous negative TRUS biopsy. World J Urol 30(2):213–218PubMedCrossRef

27.

Presti JC, O’Dowd GJ, Miller MC, Mattu R, Veltri RW (2003) Extended peripheral zone biopsy schemes increase cancer detection rates and minimize variance in prostate specific antigen and age related cancer rates: results of a community multi-practice study. J Urol 169(1):125–129PubMedCrossRef

28.

Haarer CF, Gopalan A, Tickoo SK et al (2009) Prostatic transition zone directed needle biopsies uncommonly sample clinically relevant transition zone tumors. J Urol 182(4):1337–1341PubMedCrossRef

29.

Ouzzane A, Puech P, Lemaitre L et al (2011) Combined multiparametric MRI and targeted biopsies improve anterior prostate cancer detection, staging, and grading. Urology 78(6):1356–1362PubMedCrossRef

30.

Moussa AS, Meshref A, Schoenfield L et al (2010) Importance of additional “extreme” anterior apical needle biopsies in the initial detection of prostate cancer. Urology 75(5):1034–1039PubMedCrossRef

Titel: Incremental value of transition zone and midline apical biopsy at baseline TRUS-guided biopsy for prostate cancer detection
verfasst von: D. M. Somford
W. Vreuls
T. S. Jansen
J. P. van Basten
H. Vergunst
Publikationsdatum: 01.04.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 2/2014
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-013-1130-3

Neu im Fachgebiet Urologie

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

Stufenschema weist Prostatakarzinom zuverlässig nach

22.04.2024 Prostatakarzinom Nachrichten

Erst PSA-Test, dann Kallikrein-Score, schließlich MRT und Biopsie – ein vierstufiges Screening-Schema kann die Zahl der unnötigen Prostatabiopsien erheblich reduzieren: Die Hälfte der Männer, die in einer finnischen Studie eine Biopsie benötigten, hatte einen hochgradigen Tumor.

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

20.04.2024 EAU 2024 Kongressbericht

Beim chronischen Harnwegsinfekt bei Frauen wird bisher meist eine Antibiotikaprophylaxe eingesetzt. Angesichts der zunehmenden Antibiotikaresistenz erweist sich das Antiseptikum Methenamin-Hippurat als vielversprechende Alternative, so die Auswertung einer randomisierten kontrollierten Studie.

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2014

The surgical approach can be determined from the pathological specimen obtained after open or robot-assisted laparoscopic radical prostatectomy

Quantification of median lobe protrusion and its impact on the base surgical margin status during robot-assisted laparoscopic prostatectomy

The method of GFR determination impacts the estimation of cisplatin eligibility in patients with advanced urothelial cancer

The impact of obesity on the predictive accuracy of PSA in men undergoing prostate biopsy