Pietro Pepe1, Ludovica Pepe2, Michele Pennisi2, Filippo Fraggetta3. 1. Urology Unit Cannizzaro Hospital, Catania, Italy. Electronic address: piepepe@hotmail.com. 2. Urology Unit Cannizzaro Hospital, Catania, Italy. 3. Pathology Unit Cannizzaro Hospital, Catania, Italy.
Abstract
INTRODUCTION: The reclassification rate for clinically significant prostate cancer (csPCa) has been evaluated in men enrolled in active surveillance (AS) protocol who previously underwent confirmatory biopsy. MATERIALS AND METHODS: From May 2013 to September 2017, 110 patients (median age 63 years) with very low risk PCa underwent 3-years scheduled prostate biopsy performing repeated transperineal saturation biopsy (SPBx); in addition, the mpMRI lesions characterized by Prostate Imaging Reporting and Data System (PI-RADS) version 2 scores ≥ 3 were submitted to additional mpMRI/TRUS fusion biopsies (4 cores). The reclassification rate for csPCa (over 3 or more than 10% of positive cores, ISUP Grade Group/GG ≥ 2, greatest percentage of cancer > 50%) has been evaluated. RESULTS: Six (5.4%) patients with PI-RADS score 3 (4 men) vs. 4 (2 men) were reclassified based on upgraded (GG2); SPBx and MRI/TRUS fusion biopsy diagnosed 100% and 0% of csPCa, respectively. Of the remaining 104 (94.5%) patients, 75 (72.2%) were found to have very low-risk PCa and in 29 (27.8%) cancer was absent (normal parenchyma). CONCLUSION: SPBx combined with mpMRI at confirmatory and repeated evaluation allow to reduce the reclassification rate during AS follow up (5.4% of the cases at 3 years from diagnosis).
INTRODUCTION: The reclassification rate for clinically significant prostate cancer (csPCa) has been evaluated in men enrolled in active surveillance (AS) protocol who previously underwent confirmatory biopsy. MATERIALS AND METHODS: From May 2013 to September 2017, 110 patients (median age 63 years) with very low risk PCa underwent 3-years scheduled prostate biopsy performing repeated transperineal saturation biopsy (SPBx); in addition, the mpMRI lesions characterized by Prostate Imaging Reporting and Data System (PI-RADS) version 2 scores ≥ 3 were submitted to additional mpMRI/TRUS fusion biopsies (4 cores). The reclassification rate for csPCa (over 3 or more than 10% of positive cores, ISUP Grade Group/GG ≥ 2, greatest percentage of cancer > 50%) has been evaluated. RESULTS: Six (5.4%) patients with PI-RADS score 3 (4 men) vs. 4 (2 men) were reclassified based on upgraded (GG2); SPBx and MRI/TRUS fusion biopsy diagnosed 100% and 0% of csPCa, respectively. Of the remaining 104 (94.5%) patients, 75 (72.2%) were found to have very low-risk PCa and in 29 (27.8%) cancer was absent (normal parenchyma). CONCLUSION: SPBx combined with mpMRI at confirmatory and repeated evaluation allow to reduce the reclassification rate during AS follow up (5.4% of the cases at 3 years from diagnosis).
Authors: Alberto Artiles Medina; Rafael Rodríguez-Patrón Rodríguez; Mercedes Ruiz Hernández; Marina Mata Alcaraz; Silvia García Barreras; Guillermo Fernández Conejo; Agustín Fraile Poblador; Enrique Sanz Mayayo; Francisco Javier Burgos Revilla Journal: Res Rep Urol Date: 2021-09-27
Authors: Pietro Pepe; Marco Roscigno; Ludovica Pepe; Paolo Panella; Marinella Tamburo; Giulia Marletta; Francesco Savoca; Giuseppe Candiano; Sebastiano Cosentino; Massimo Ippolito; Andreas Tsirgiotis; Michele Pennisi Journal: J Clin Med Date: 2022-06-16 Impact factor: 4.964