Clinically significant prostate cancer (csPCa) detection with various prostate sampling schemes based on different csPCa definitions

BMC Urology

Qi Ma¹  Caishan Wang¹  Tong Chen¹  Meng Wang¹  Jing Luo¹  Songtao Liu¹  Peiqing Liu¹  Fei Wang¹  Hanbing Chen¹  Lijun Xu² 

[1] Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, China;Department of Urology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, China;

关键词: Clinically significant prostate cancer;    Contralateral;    Ipsilateral;    Systematic biopsy;    Targeted biopsy;   

DOI  :  10.1186/s12894-021-00949-7

来源: Springer

【 摘 要 】

BackgroundCombining targeted biopsy (TB) with systematic biopsy (SB) is currently recommended as the first-line biopsy method by the European Association of Urology (EAU) guidelines in patients diagnosed with prostate cancer (PCa) with an abnormal magnetic resonance imaging (MRI). The combined SB and TB indeed detected an additional number of patients with clinically significant prostate cancer (csPCa); however, it did so at the expense of a concomitant increase in biopsy cores. Our study aimed to evaluate if ipsilateral SB (ipsi-SB) + TB or contralateral SB (contra-SB) + TB could achieve almost equal csPCa detection rates as SB + TB using fewer cores based on a different csPCa definition.MethodsPatients with at least one positive prostate lesion were prospectively diagnosed by MRI. The combination of TB and SB was conducted in all patients. We compared the csPCa detection rates of the following four hypothetical biopsy sampling schemes with those of SB + TB: SB, TB, ipsi-SB + TB, and contra-SB + TB.ResultsThe study enrolled 279 men. The median core of SB, TB, ipsi-SB + TB, and contra-SB + TB was 10, 2, 7 and 7, respectively (P < 0.001). ipsi-SB + TB detected significantly more patients with csPCa than contra-SB + TB based on the EAU guidelines (P = 0.042). They were almost equal on the basis of the Epstein criteria (P = 1.000). Compared with SB + TB, each remaining method detected significantly fewer patients with csPCa regardless of the definition (P < 0.001) except ipsi-SB + TB on the grounds of D1 (P = 0.066). Ten additional subjects were identified with a higher Gleason score (GS) on contra-SB + TB, and only one was considered as significantly upgraded (GS = 6 on ipsi-SB + TB to a GS of 8 on contra-SB + TB).ConclusionsIpsi-SB + TB could acquire an almost equivalent csPCa detection value to SB + TB using significantly fewer cores when csPCa was defined according to the EAU guidelines. Given that there was only one significantly upgrading patient on contra-SB, our results suggested that contra-SB could be avoided.

【 授权许可】

CC BY