Identifying the index lesion with template prostate mapping biopsies.

Détails

ID Serval
serval:BIB_C17BA00B68EE
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Identifying the index lesion with template prostate mapping biopsies.
Périodique
Journal of Urology
Auteur(s)
Valerio M., Anele C., Freeman A., Jameson C., Singh P.B., Hu Y., Emberton M., Ahmed H.U.
ISSN
1527-3792 (Electronic)
ISSN-L
0022-5347
Statut éditorial
Publié
Date de publication
2015
Peer-reviewed
Oui
Volume
193
Numéro
4
Pages
1185-1190
Langue
anglais
Notes
Publication types: Journal Article Publication Status: ppublish
Résumé
PURPOSE: The natural history of prostate cancer might be driven by the index lesion. We determined the percent of men in whom the index lesion could be defined using transperineal template prostate mapping biopsies.
MATERIALS AND METHODS: Included in study were consecutive men undergoing transperineal template prostate mapping biopsies with biopsies grouped into 20 zones. Men with clinically significant disease in only 1 prostate area were considered to have an identifiable index lesion. We evaluated the impact of using 2 definitions of clinically significant disease (Gleason grade pattern 4 and/or lesion volume 0.5 cc or greater) and 2 clustering rules (stringent and tolerant) to define the index lesion.
RESULTS: Included in study were 391 men with a median age of 62 years (IQR 58-67) and a median prostate specific antigen of 6.9 ng/ml (IQR 4.8-10.0). Of the men 269 (69%) were previously diagnosed with prostate cancer. By deploying a median of 1.2 cores per ml (IQR 0.9-1.7) cancer was diagnosed in 82.9% of the men (324 of 391) with a median of 6 positive cores (IQR 2-9), a median maximum cancer core length of 5 mm (IQR 3-8) and a total cancer core length per zone of 7 mm (IQR 3-13). Insignificant disease was found in 26.3% to 42.9% of cases. When a stringent spatial relationship was used to define individual lesions, 44.4% to 54.6% of patients had 1 index lesion and 12.7% to 19.1% had more than 1 area with clinically significant disease. These proportions changed to 46.6% to 59.2% and 10.5% to 14.5%, respectively, when less stringent spatial clustering was applied.
CONCLUSIONS: Transperineal template prostate mapping biopsies enable the index lesion to be localized in most men with clinically significant disease. This information may be important to select appropriate candidates for targeted therapy and to plan a tailored treatment strategy in men undergoing radical therapy.
Pubmed
Web of science
Création de la notice
28/04/2015 18:05
Dernière modification de la notice
03/03/2018 21:08
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