OBJECTIVE: To evaluate the role of transperineal template prostate biopsies in men on active surveillance. PATIENTS AND METHODS: In all, 101 men on active surveillance for prostate cancer underwent restaging transperineal template prostate biopsies at a single centre. Criteria for active surveillance were ≤75 years, Gleason ≤3+3, prostate-specific antigen (PSA) ≤15 ng/mL, clinical stage T1-2a and ≤50% ultrasound-guided transrectal biopsy cores positive for cancer with ≤10 mm of disease in a single core. The number of men with an increase in disease volume or Gleason grade on transperineal template biopsy and the number of men who later underwent radical treatment were assessed. The role of PSA and PSA kinetics were studied. RESULTS: In all, 34% of men had more significant prostate cancer on restaging transperineal template biopsies compared with their transrectal biopsies. Of these men, 44% had disease predominantly in the anterior part of the gland, an area often under-sampled by transrectal biopsies. In the group of men who had their restaging transperineal template biopsies within 6 months of commencing active surveillance 38% had more significant disease. There was no correlation with PSA velocity or PSA doubling time. In total, 33% of men stopped active surveillance and had radical treatment. CONCLUSIONS: Around one-third of men had more significant prostate cancer on transperineal template biopsies. This probably reflects under-sampling by initial transrectal biopsies rather than disease progression.
OBJECTIVE: To evaluate the role of transperineal template prostate biopsies in men on active surveillance. PATIENTS AND METHODS: In all, 101 men on active surveillance for prostate cancer underwent restaging transperineal template prostate biopsies at a single centre. Criteria for active surveillance were ≤75 years, Gleason ≤3+3, prostate-specific antigen (PSA) ≤15 ng/mL, clinical stage T1-2a and ≤50% ultrasound-guided transrectal biopsy cores positive for cancer with ≤10 mm of disease in a single core. The number of men with an increase in disease volume or Gleason grade on transperineal template biopsy and the number of men who later underwent radical treatment were assessed. The role of PSA and PSA kinetics were studied. RESULTS: In all, 34% of men had more significant prostate cancer on restaging transperineal template biopsies compared with their transrectal biopsies. Of these men, 44% had disease predominantly in the anterior part of the gland, an area often under-sampled by transrectal biopsies. In the group of men who had their restaging transperineal template biopsies within 6 months of commencing active surveillance 38% had more significant disease. There was no correlation with PSA velocity or PSA doubling time. In total, 33% of men stopped active surveillance and had radical treatment. CONCLUSIONS: Around one-third of men had more significant prostate cancer on transperineal template biopsies. This probably reflects under-sampling by initial transrectal biopsies rather than disease progression.
Authors: Findlay MacAskill; Su-Min Lee; David Eldred-Evans; Wahyu Wulaningsih; Rick Popert; Konrad Wolfe; Mieke Van Hemelrijck; Giles Rottenberg; Sidath H Liyanage; Peter Acher Journal: Int Urol Nephrol Date: 2017-05-05 Impact factor: 2.370
Authors: Vassilios M Skouteris; E David Crawford; Vladimir Mouraviev; Paul Arangua; Marios Panagiotis Metsinis; Michael Skouteris; George Zacharopoulos; Nelson N Stone Journal: Rev Urol Date: 2018
Authors: Rui Li; Sheng Xu; Ivane Bakhutashvili; Ismail B Turkbey; Peter Choyke; Peter Pinto; Bradford Wood; Zion T H Tse Journal: Ann Biomed Eng Date: 2018-11-28 Impact factor: 3.934