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Comparison of Gleason upgrading rates in transrectal ultrasound systematic random biopsies versus US-MRI fusion biopsies for prostate cancer
Kayano, Paulo Priante; Carneiro, Arie; Castilho, Tiago Mendonça Lopez; Sivaraman, Arjun; Claros, Oliver Rojas; Baroni, Ronaldo Hueb; Garcia, Rodrigo Gobbo; Mariotti, Guilherme Cayres; Smaletz, Oren; Filippi, Renne Zon; Lemos, Gustavo Caserta.
Afiliación
  • Kayano, Paulo Priante; Hospital Israelita Albert Einstein. São Paulo. BR
  • Carneiro, Arie; Hospital Israelita Albert Einstein. São Paulo. BR
  • Castilho, Tiago Mendonça Lopez; Hospital Israelita Albert Einstein. São Paulo. BR
  • Sivaraman, Arjun; Memorial Sloan Kettering Cancer Center. New York. US
  • Claros, Oliver Rojas; Hospital Israelita Albert Einstein. São Paulo. BR
  • Baroni, Ronaldo Hueb; Hospital Israelita Albert Einstein. São Paulo. BR
  • Garcia, Rodrigo Gobbo; Hospital Israelita Albert Einstein. São Paulo. BR
  • Mariotti, Guilherme Cayres; Hospital Israelita Albert Einstein. São Paulo. BR
  • Smaletz, Oren; Hospital Israelita Albert Einstein. São Paulo. BR
  • Filippi, Renne Zon; Hospital Israelita Albert Einstein. São Paulo. BR
  • Lemos, Gustavo Caserta; Hospital Israelita Albert Einstein. São Paulo. BR
Int. braz. j. urol ; 44(6): 1106-1113, Nov.-Dec. 2018. tab, graf
Article en En | LILACS | ID: biblio-975665
Biblioteca responsable: BR1.1
ABSTRACT
ABSTRACT

Purpose:

Ultrasound-magnetic resonance imaging (US-MRI) fusion biopsy (FB) improves the detection of clinically significant prostate cancer (PCa). We aimed to compare the Gleason upgrading (GU) rates and the concordance of the Gleason scores in the biopsy versus final pathology after surgery in patients who underwent transrectal ultrasound (TRUS) systematic random biopsies (SRB) versus US-MRI FB for PCa. Materials and

Methods:

A retrospective analysis of data that were collected prospectively from January 2011 to June 2016 from patients who underwent prostate biopsy and subsequent radical prostatectomy. The study cohort was divided into two groups US-MRI FB (Group A) and TRUS SRB (Group B). US-MRI FB was performed in patients with a previous MRI with a focal lesion with a Likert score ≥3; otherwise, a TRUS SRB was performed.

Results:

In total, 73 men underwent US-MRI FB, and 89 underwent TRUS SRB. The GU rate was higher in Group B (31.5% vs. 16.4%; p=0.027). According to the Gleason grade pattern, GU was higher in Group B than in Group A (40.4% vs. 23.3%; p=0.020). Analyses of the Gleason grading patterns showed that Gleason scores 3+4 presented less GU in Group A (24.1% vs. 52.6%; p=0.043). The Bland-Altman plot analysis showed a higher bias in Group B than in Group A (-0.27 [-1.40 to 0.86] vs. −0.01 [-1.42 to 1.39]). In the multivariable logistic regression analysis, the only independent predictor of GU was the use of TRUS SRB (2.64 [1.11 - 6.28]; p=0.024).

Conclusions:

US-MRI FB appears to be related to a decrease in GU rate and an increase in concordance between biopsy and final pathology compared to TRUS SRB, suggesting that performing US-MRI FB leads to greater accuracy of diagnosis and better treatment decisions.
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Texto completo: 1 Base de datos: LILACS Asunto principal: Neoplasias de la Próstata / Ultrasonografía Intervencional / Imagen por Resonancia Magnética Intervencional / Biopsia Guiada por Imagen Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans / Male Idioma: En Revista: Int. braz. j. urol Asunto de la revista: UROLOGIA Año: 2018 Tipo del documento: Article País de afiliación: Brasil / Estados Unidos

Texto completo: 1 Base de datos: LILACS Asunto principal: Neoplasias de la Próstata / Ultrasonografía Intervencional / Imagen por Resonancia Magnética Intervencional / Biopsia Guiada por Imagen Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans / Male Idioma: En Revista: Int. braz. j. urol Asunto de la revista: UROLOGIA Año: 2018 Tipo del documento: Article País de afiliación: Brasil / Estados Unidos