INTRODUCTION: The aim of this study is to examine if guided prostate biopsies based on abnormalities detected by conventional and functional endorectal magnetic resonance imaging (MRI) yield a more reliable representation of the radical prostatectomy pathology and to identify probable preoperative clinical variables that stratified patients likely to harbor significant upgrading. PATIENTS AND METHODS: From April 2004 to April 2009, a review of N=70 patients records diagnosed with prostate cancer by a 3-6 core guided transrectal ultrasound (TRUS) prostate biopsy based on abnormalities detected by conventional and functional endorectal MRI and who subsequently underwent radical prostatectomy and exhibited a significant upgrading was conducted. Additionally, a multivariate analysis with a significant upgrading as the outcome was performed including the following parameters: prostate specific antigen (PSA) level, clinical stage, prostate size and duration from biopsy to radical prostatectomy. RESULTS: A significant upgrading was noted in only 8.5% of patients, with 1.4% exhibiting a significant downgrading and the rest 90.1% exhibiting an exact Gleason score match. No preoperative clinical variables that stratified patients likely to harbour significant upgrading were identified. CONCLUSIONS: This type of biopsy method seems to solve the discordance between the biopsy Gleason score and radical prostatectomy pathology regardless of known preoperative clinical variables that can affect it.
INTRODUCTION: The aim of this study is to examine if guided prostate biopsies based on abnormalities detected by conventional and functional endorectal magnetic resonance imaging (MRI) yield a more reliable representation of the radical prostatectomy pathology and to identify probable preoperative clinical variables that stratified patients likely to harbor significant upgrading. PATIENTS AND METHODS: From April 2004 to April 2009, a review of N=70 patients records diagnosed with prostate cancer by a 3-6 core guided transrectal ultrasound (TRUS) prostate biopsy based on abnormalities detected by conventional and functional endorectal MRI and who subsequently underwent radical prostatectomy and exhibited a significant upgrading was conducted. Additionally, a multivariate analysis with a significant upgrading as the outcome was performed including the following parameters: prostate specific antigen (PSA) level, clinical stage, prostate size and duration from biopsy to radical prostatectomy. RESULTS: A significant upgrading was noted in only 8.5% of patients, with 1.4% exhibiting a significant downgrading and the rest 90.1% exhibiting an exact Gleason score match. No preoperative clinical variables that stratified patients likely to harbour significant upgrading were identified. CONCLUSIONS: This type of biopsy method seems to solve the discordance between the biopsy Gleason score and radical prostatectomy pathology regardless of known preoperative clinical variables that can affect it.
Authors: M Roethke; A G Anastasiadis; M Lichy; M Werner; P Wagner; S Kruck; Claus D Claussen; A Stenzl; H P Schlemmer; D Schilling Journal: World J Urol Date: 2011-04-22 Impact factor: 4.226