146 PROSTATE CANCER DETECTION RATE ACCORDING TO CANCER TRUE PREVALENCE: EVALUATION OF THE TOTAL TUMOR VOLUME MISSED BY BIOPSIES

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology and Natural History1 Apr 2011146 PROSTATE CANCER DETECTION RATE ACCORDING TO CANCER TRUE PREVALENCE: EVALUATION OF THE TOTAL TUMOR VOLUME MISSED BY BIOPSIES Nicolas Delongchamps, Gustavo Dela Roza de la Roza, Vishal Chandan, Richard Jones, Gregory Threatte, Mary Jumbelic, and Gabriel Haas Nicolas DelongchampsNicolas Delongchamps Paris, France, Metropolitan More articles by this author , Gustavo Dela Roza de la RozaGustavo Dela Roza de la Roza Syracuse, NY More articles by this author , Vishal ChandanVishal Chandan Syracuse, NY More articles by this author , Richard JonesRichard Jones Syracuse, NY More articles by this author , Gregory ThreatteGregory Threatte Syracuse, NY More articles by this author , Mary JumbelicMary Jumbelic Syracuse, NY More articles by this author , and Gabriel HaasGabriel Haas Syracuse, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.214AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Using autopsy prostates, we previously reported that prostate 12-core biopsies missed almost half of cancers, based on true prevalence. Using an 18-core biopsy protocol, we evaluated the cumulative volume of cancers detected, and assessed the effects of increased biopsy sampling on overall tumor volume detection. METHODS We performed 18 core needle biopsies on 212 autopsy prostates from men deceased with no history of prostate cancer. The first six cores were taken from the mid peripheral zone (MPZ), the next 6 cores from the lateral PZ (LPZ), and the last six cores from the central zone (CZ). We correlated the number of cancers and tumor foci detected, as well as their corresponding cumulative tumor volume with biopsy findings. Cumulative total tumor volume (TTV) was calculated by adding all tumor volumes. RESULTS Whole-mount analysis identified 59 cancers, corresponding to 110 tumor foci and a cumulative TTV of 44.6 cm3. Of the 110 tumor foci, 25 (23%), 40 (36%) and 47 (43%) were detected with MPZ, MPZ plus LPZ, and all 18 biopsies, respectively. The corresponding cumulative tumor volume detected was of 17.9, 22.4 and 31.8 cm3, respectively. Although CZ biopsies detected only 7 additional tumor foci, these foci represented 21% of the cumulative TTV. Of the 59 cancers, 18 (30%), 31 (52%) and 32 (54%) were detected with MPZ, MPZ plus LPZ, and all 18 biopsies, respectively. The overall cumulative tumor volume of the 32 cancers detected was of 37.5 cm3 (84% of the total cumulative volume of cancer). Figure legend volume (in mm3) of tumors detected and missed by biopsies CONCLUSIONS Although 57% of tumor foci and 53% of cancers were missed by biopsies, they represented only 16% of the overall cumulative TTV. A 12-core biopsy protocol triggering the MPZ and LPZ performed best for cancer detection. Biopsies triggering the CZ detected only 7 additional foci but almost ¼ of the overall cumulative TTV. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e61-e62 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nicolas Delongchamps Paris, France, Metropolitan More articles by this author Gustavo Dela Roza de la Roza Syracuse, NY More articles by this author Vishal Chandan Syracuse, NY More articles by this author Richard Jones Syracuse, NY More articles by this author Gregory Threatte Syracuse, NY More articles by this author Mary Jumbelic Syracuse, NY More articles by this author Gabriel Haas Syracuse, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...