Location and Pathological Characteristics of Cancers in Radical Prostatectomy Specimens Identified by Transperineal Biopsy Compared to Transrectal Biopsy

被引:92
作者
Hossack, Tania [1 ]
Patel, Manish I. [5 ]
Huo, Andrew [4 ]
Brenner, Phillip
Yuen, Carlo
Spernat, Daniel
Mathews, Jayne [2 ,3 ]
Haynes, Anne-Marie [4 ]
Sutherland, Rob [4 ]
Del Prado, Warick [6 ]
Stricker, Phillip
机构
[1] St Vincents Hosp, Dept Urol, Darlinghurst, NSW 2010, Australia
[2] Prostate Canc Ctr, Darlinghurst, NSW, Australia
[3] St Vincents Clin, Darlinghurst, NSW 2010, Australia
[4] St Vincents Hosp, Garvan Inst Med Res, Canc Res Program, Darlinghurst, NSW 2010, Australia
[5] Univ Sydney, Urol Canc Outcomes Ctr, Sydney, NSW, Australia
[6] Douglass Hanly Moir Pathol, Sydney, NSW, Australia
基金
英国医学研究理事会;
关键词
prostatic neoplasms; pathology; prostatectomy; biopsy; needle; diagnosis; LOCAL-ANESTHESIA; ANTERIOR; METAANALYSIS; TUMORS;
D O I
10.1016/j.juro.2012.05.006
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose: Anterior tumors are estimated to constitute 20% of prostate cancers. Current data indicate that transperineal biopsy is more reliable than transrectal biopsy in identifying these tumors. If correct, this superior reliability should result in an increased proportion of anterior tumors identified by transperineal biopsy. We investigated this hypothesis with reference to prostatectomy specimens. Materials and Methods: Radical prostatectomy histopathology records were retrospectively examined. Patients were grouped based on primary transperineal or transrectal biopsy as the modality used to identify the initial cancer. After grouping, tumor location and size were recorded and, thus, the proportion of anterior tumors was determined. Results: A total of 1,132 (414 transperineal and 718 transrectal) prostatectomy specimens were examined. Overall mean tumor size (1.8 and 2.0 cm(3)), stage (pT2 63.3% and 61%) and significance (5.1% and 5.1%) for the transperineal and transrectal methods were similar. However, the transperineal method was associated with proportionally more anterior tumors (16.2% vs 12%, p = 0.046), and identified them at a smaller size (1.4 vs 2.1 cm(3), p = 0.03) and lower stage (extracapsular extension 13% vs 28%, p = 0.03) compared to the transrectal method. The pT3 positive surgical margin rate for anterior vs other tumors was 69% vs 34.9%, respectively. Conclusions: Overall transrectal and transperineal biopsy identify cancers that are similar in size, stage and significance. However, transperineal biopsy detected proportionally more anterior tumors (16.2% vs 12%), and identified them at a smaller size (1.4 vs 2.1 cm(3)) and stage (extracapsular extension 13% vs 28%) compared to transrectal biopsy. Identifying anterior tumors early is important because the positive surgical margin rate for anterior pT3 lesions is significantly higher.
引用
收藏
页码:781 / 785
页数:5
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