Izvorni znanstveni članak
https://doi.org/10.20471/acc.2022.61.s3.4
Comparison of Grading Accuracy of Prostate Cancer in Samples Acquired by a Targeted and Systemic Prostate Biopsy
Ivan Pezelj
orcid.org/0000-0001-7083-7672
; Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Matea Pirša
orcid.org/0000-0002-3838-5423
; Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Ivan Svaguša
; Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Sven Nikles
orcid.org/0000-0001-6496-5061
; Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Miroslav Tomić
orcid.org/0000-0001-6389-2518
; Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Matej Knežević
; Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Igor Tomašković
orcid.org/0000-0003-4182-9707
; Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Božo Krušlin
orcid.org/0000-0002-0480-1687
; Ljudevit Jurak Clinical Department of Pathology and Cytology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Sažetak
All malignancies, including prostate cancer, require accurate diagnosing and staging
before making a treatment decision. The introduction of targeted biopsies based on prostate MRI findings
has raised prostate biopsy accuracy. Guided biopsies target the tumor itself during the biopsy instead
of the most common tumor sites as is the case with a systemic biopsy. Some studies report that targeted
biopsies should lower prostate cancer biopsy undergrading and overgrading.
To determine the incidence of prostate cancer biopsy undergrading in patients who underwent
a classic systemic biopsy compared to patients who underwent a mpMRI cognitive targeted biopsy.
We identified the patients from our database who underwent a radical prostatectomy
at our institution from January 1st, 2021, to June 30th, 2021.There were 112 patients identified.
Patients were stratified into two groups based on the type of biopsy that confirmed prostate cancer.
The mpMRI (N=50) group had a mpMRI cognitive guided transrectal ultrasound (TRUS) prostate
biopsy performed, and the non-mpMRI group (N=62) received a classic, systemic TRUS biopsy. We
compared the biopsy results with the final pathological results, and searched for undergrading or overgrading
in the biopsies compared to the final histological reportThe undergrading was found in 17,7 % (N=11) cases in the non-mpMRI group and in 12,0
% (N=6) of cases in the mpMRI group (p=0,02, Mann-Whitney U test). No overgrading was found in
our cohort. All cases of undergrading had Grade Group 1 in the biopsy report and Grade Group 2 in the
final specimen report. The charasteristics of patients are listed in Table 1.
In our cohort, the patients who underwent a mpMRI targeted biopsy
had a lower undergrading incidence. During a systemic TRUS biopsy, the urologist targets the areas of
the prostate where cancer is most commonly located, which is usually the peripheral zone of the prostate.
Since different areas of the tumor have different areas of differentiation, only a low-grade part of the
tumor is sometimes biopsied, which results in a sampling error. Once the prostate is removed, the whole
tumor is analyzed, so the obtained pathological results related to the removed prostate are far more accurate
than the analysis of prostate cores obtained by biopsy.
Ključne riječi
Prostate Cancer; Undegrading; Overgrading; Prostate Biopsy; Prostate MRI
Hrčak ID:
286333
URI
Datum izdavanja:
1.10.2022.
Posjeta: 592 *