BACKGROUND: Studies offer wide variations in inclusion criteria for active surveillance (AS) in prostate cancer (PCa), but the role of the biopsy core number has not been thoroughly assessed. OBJECTIVE: To evaluate the impact of the biopsy core number on the risk of misclassification for AS eligibility. DESIGN, SETTING, AND PARTICIPANTS: This prospective study included 411 men eligible for AS who fulfilled at least one of four of the criteria reported in the literature groupings among a screening cohort of 2917 patients. INTERVENTION: All patients underwent a 21-core biopsy with cores mapped by location and acted as controls of themselves for the analysis of biopsy core number (6-, 12- and 21-core schemes). Radical prostatectomy (RP) was performed in 297 men (72%). MEASUREMENTS: The number of included patients, PCa extent on biopsy, rate of unfavorable disease in RP specimens, and biochemical recurrence-free survival were compared as a function of (1) the different criteria groupings for AS and (2) the biopsy core number (6, 12, or 21). RESULTS AND LIMITATIONS: Of the 1104 patients with PCa, the proportion eligible for AS ranged from 22.5% to 35.4% based on AS criteria. In men who fulfilled AS criteria only in a 12-core strategy, tumor length and percentage of cancer involvement on biopsy were significantly greater than in those who fulfilled AS criteria in a 21-core scheme. The rate of unfavorable disease on RP specimens was also higher in the former group, from 28.6% to 35.9% relative to AS criteria (p=0.014, 0.044, and 0.113 in groups 2, 3, and 4, respectively). CONCLUSIONS: Men eligible for AS based on a 21-core strategy have cancers with a lower extent of disease on biopsies and a lower risk of unfavorable disease on RP specimens regardless of how AS criteria are defined, compared with men eligible in a 12-core scheme.
BACKGROUND: Studies offer wide variations in inclusion criteria for active surveillance (AS) in prostate cancer (PCa), but the role of the biopsy core number has not been thoroughly assessed. OBJECTIVE: To evaluate the impact of the biopsy core number on the risk of misclassification for AS eligibility. DESIGN, SETTING, AND PARTICIPANTS: This prospective study included 411 men eligible for AS who fulfilled at least one of four of the criteria reported in the literature groupings among a screening cohort of 2917 patients. INTERVENTION: All patients underwent a 21-core biopsy with cores mapped by location and acted as controls of themselves for the analysis of biopsy core number (6-, 12- and 21-core schemes). Radical prostatectomy (RP) was performed in 297 men (72%). MEASUREMENTS: The number of included patients, PCa extent on biopsy, rate of unfavorable disease in RP specimens, and biochemical recurrence-free survival were compared as a function of (1) the different criteria groupings for AS and (2) the biopsy core number (6, 12, or 21). RESULTS AND LIMITATIONS: Of the 1104 patients with PCa, the proportion eligible for AS ranged from 22.5% to 35.4% based on AS criteria. In men who fulfilled AS criteria only in a 12-core strategy, tumor length and percentage of cancer involvement on biopsy were significantly greater than in those who fulfilled AS criteria in a 21-core scheme. The rate of unfavorable disease on RP specimens was also higher in the former group, from 28.6% to 35.9% relative to AS criteria (p=0.014, 0.044, and 0.113 in groups 2, 3, and 4, respectively). CONCLUSIONS:Men eligible for AS based on a 21-core strategy have cancers with a lower extent of disease on biopsies and a lower risk of unfavorable disease on RP specimens regardless of how AS criteria are defined, compared with men eligible in a 12-core scheme.
Authors: Ramzi Rajab; Gabrielle Fisher; Michael W Kattan; Christopher S Foster; Tim Oliver; Henrik Møller; Victor Reuter; Peter Scardino; Jack Cuzick; Daniel M Berney Journal: Virchows Arch Date: 2010-09-09 Impact factor: 4.064
Authors: J P Radtke; T H Kuru; D Bonekamp; M T Freitag; M B Wolf; C D Alt; G Hatiboglu; S Boxler; S Pahernik; W Roth; M C Roethke; H P Schlemmer; M Hohenfellner; B A Hadaschik Journal: Prostate Cancer Prostatic Dis Date: 2016-05-17 Impact factor: 5.554
Authors: Hiten D Patel; Zhaoyong Feng; Patricia Landis; Bruce J Trock; Jonathan I Epstein; H Ballentine Carter Journal: J Urol Date: 2013-09-20 Impact factor: 7.450
Authors: Ottavio de Cobelli; Daniela Terracciano; Elena Tagliabue; Sara Raimondi; Danilo Bottero; Antonio Cioffi; Barbara Jereczek-Fossa; Giuseppe Petralia; Giovanni Cordima; Gilberto Laurino Almeida; Giuseppe Lucarelli; Carlo Buonerba; Deliu Victor Matei; Giuseppe Renne; Giuseppe Di Lorenzo; Matteo Ferro Journal: PLoS One Date: 2015-10-07 Impact factor: 3.240