Andrea Fandella1, Vincenzo Scattoni2, Andrea Galosi3, Pietro Pepe4, Michelangelo Fiorentino5, Caterina Gaudiano6, Marco Giampaoli7, Roberta Gunelli8, Pasquale Martino9, Vittorino Montanaro10, Rodolfo Montironi11, Tiziana Pierangeli12, Armando Stabile13, Alessandro Bertaccini7. 1. Department of Urology, Giovanni XXIII Clinic, Monastier di Treviso, Treviso, Italy. 2. Department of Urology, San Raffaele Hospital, Milan, Italy scattoni.vincenzo@hsr.it. 3. Institute of Urology, Marche Polytechnic University, Riuniti Hospital, Ancona, Italy. 4. Department of Urology, Canizzaro Hospital, Catania, Italy. 5. Department of Pathology, F. Addari Institute of Oncology, S. Orsola Hospital, Bologna, Italy. 6. Department of Radiology, S. Orsola - Malpighi Hospital, University of Bologna, Bologna, Italy. 7. Institute of Urology, S. Orsola - Malpighi Hospital, University of Bologna, Bologna, Italy. 8. Department of Urology, Hospital of Forlì, Forlì, Italy. 9. Department of Urology, University of Bari, Bari, Italy. 10. Department of Urology, Federico II University Hospital, Naples, Italy. 11. Institute of Pathology, Marche Polytechnic University, Ancona, Italy. 12. Prostate Cancer Prevention Unit, Department of Urology, INRCA, Ancona, Italy. 13. Department of Urology, San Raffaele Hospital, Milan, Italy.
Abstract
AIM: To present a summary of the updated guidelines of the Italian Prostate Biopsies Group following the best recent evidence of the literature. MATERIALS AND METHODS: A systematic review of the new data emerging from 2012-2015 was performed by a panel of 14 selected Italian experts in urology, pathology and radiology. The experts collected articles published in the English-language literature by performing a search using Medline, EMBASE and the Cochrane Library database. The articles were evaluated using a systematic weighting and grading of the level of the evidence according to the Grading of Recommendations Assessment, Development and Evaluation framework system. RESULTS: An initial prostate biopsy is strongly recommended when i) prostate specific antigen (PSA) >10 ng/ml, ii) digital rectal examination is abnormal, iii) multiparametric magnetic resonance imaging (mpMRI) has a Prostate Imaging Reporting and Data System (PIRADS) ≥4, even if it is not recommended. The use of mpMRI is strongly recommended only in patients with previous negative biopsy. At least 12 cores should be taken in each patient plus targeted (fusion or cognitive) biopsies of suspicious area (at mpMRI or transrectal ultrasound). Saturation biopsies are optional in all settings. The optimal strategy for reducing infection complications is still a controversial topic and the instruments to reduce them are actually weak. The adoption of Gleason grade groups in adjunction to the Gleason score when reporting prostate biopsy results is advisable. CONCLUSION: These updated guidelines and recommendations are intended to assist physicians and patients in the decision-making regarding when and how to perform a prostatic biopsy. Copyright
AIM: To present a summary of the updated guidelines of the Italian Prostate Biopsies Group following the best recent evidence of the literature. MATERIALS AND METHODS: A systematic review of the new data emerging from 2012-2015 was performed by a panel of 14 selected Italian experts in urology, pathology and radiology. The experts collected articles published in the English-language literature by performing a search using Medline, EMBASE and the Cochrane Library database. The articles were evaluated using a systematic weighting and grading of the level of the evidence according to the Grading of Recommendations Assessment, Development and Evaluation framework system. RESULTS: An initial prostate biopsy is strongly recommended when i) prostate specific antigen (PSA) >10 ng/ml, ii) digital rectal examination is abnormal, iii) multiparametric magnetic resonance imaging (mpMRI) has a Prostate Imaging Reporting and Data System (PIRADS) ≥4, even if it is not recommended. The use of mpMRI is strongly recommended only in patients with previous negative biopsy. At least 12 cores should be taken in each patient plus targeted (fusion or cognitive) biopsies of suspicious area (at mpMRI or transrectal ultrasound). Saturation biopsies are optional in all settings. The optimal strategy for reducing infection complications is still a controversial topic and the instruments to reduce them are actually weak. The adoption of Gleason grade groups in adjunction to the Gleason score when reporting prostate biopsy results is advisable. CONCLUSION: These updated guidelines and recommendations are intended to assist physicians and patients in the decision-making regarding when and how to perform a prostatic biopsy. Copyright
Authors: Christopher J McNally; Joanne Watt; Mary Jo Kurth; John V Lamont; Tara Moore; Peter Fitzgerald; Hardev Pandha; Declan J McKenna; Mark W Ruddock Journal: Front Oncol Date: 2022-05-19 Impact factor: 5.738