2056 LOCATION AND PATHOLOGICAL CHARACTERISTICS OF CANCERS IN RADICAL PROSTATECTOMY SPECIMENS IDENTIFIED BY TRANS-PERINEAL BIOPSY COMPARED TO TRANS-RECTAL BIOPSY

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening IV1 Apr 20122056 LOCATION AND PATHOLOGICAL CHARACTERISTICS OF CANCERS IN RADICAL PROSTATECTOMY SPECIMENS IDENTIFIED BY TRANS-PERINEAL BIOPSY COMPARED TO TRANS-RECTAL BIOPSY Tania Hossack, Manish Patel, Phillip Brenner, Carlo Yuen, Daniel Spernat, Andrew Huo, and Phillip Stricker Tania HossackTania Hossack Sydney, Australia More articles by this author , Manish PatelManish Patel Sydney, Australia More articles by this author , Phillip BrennerPhillip Brenner Sydney, Australia More articles by this author , Carlo YuenCarlo Yuen Sydney, Australia More articles by this author , Daniel SpernatDaniel Spernat Sydney, Australia More articles by this author , Andrew HuoAndrew Huo Sydney, Australia More articles by this author , and Phillip StrickerPhillip Stricker Sydney, Australia More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2221AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Anterior located tumors are estimated to constitute 20% of all prostate cancers. Current data indicates that trans-perineal (TP) biopsies are more reliable than trans-rectal (TR) biopsies in identifying these tumors. If correct, then this superior reliability should be reflected in higher proportion of anterior tumors identified by TP biopsies compared to TR biopsies. In addition if TP biopsy is identifying more anterior tumors then this should translate into two advantages. Firstly it should identify anterior tumors when they are smaller and lower stage compared to TR identified tumors. Secondly it should aid the surgeon in operative planning therefore decrease the positive margin rate. The aims of this project therefore were: 1 To quantify the percent of anterior located tumors on radical prostatectomy specimens in men whose cancer was identified by primary TP compared to TR prostate biopsy. 2 To qualify the size, stage and grade of these anteriorly located tumors. 3 To document the positive anterior margin rate. METHODS Histopathology records of patients who underwent radical prostatectomy between 2004-2010 were examined. Patients were grouped into two categories: 1. Cancers identified by primary TP biopsy 2. Cancers detected by TR biopsy. After grouping, the location and size of the main tumor was recorded. From this, the proportion of anterior located tumors was determined. RESULTS 1132 radical prostatectomy specimens were examined. 414 cancers were detected by TP and 718 by TR. For TP, 67 (16.2%) of cancers were anterior only compared to 86 (12%) for TR (p=0.046). TP also identified tumors at a smaller size (1.4 cm3) compared to TR (2.1 cm3) (p=0.03). TP detected tumors were also more likely to be organ confined, with extra-capsular extension (ECE) present in 13% of TP compared to 27% of TR specimens (p=0.045). CONCLUSIONS Primary trans-perineal biopsy of the prostate detects more anteriorly located cancers compared to trans-rectal biopsy (16.2% vs 12%). It also identifies them at a smaller size and stage compared. This implies that trans-rectal biopsy can miss significant anterior cancers or can only identify them at a more advanced stage compared to TP biopsy. Characteristics for anterior only tumors TP versus TR group Variable TP Group TR Group Stats n (%) 67(16.2) 86(12) p=0.046 Tumour Size Mean 1.4cm3 2.1cm3 p=0.03 SD ±1.1 ±2.2 Prostate size Mean 59 cc 53 cc P>0.05 SD ±24 ±22 >80 cc 16% 6% p=0.05 Gleason Score P>0.05 ≤6 11(16) 18(21) 7 54(81) 63(73) ≥8 2(3) 4(6) Stage T2 57(85) 62(72) p=0.055 T3a 9(13) 23(27) T3b 1(2) 0 AnyT,N1 0 1(1) ECE 9(13) 23(27) p=0.045 PSM T2 12(21) 1(2) p=0.001 T3 6(60) 17(74) P.0.05 Total 18(27) 18(21) p>0.05 Insignificant cancer 7(10%) 7(8.1%) p>0.05 © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e829-e830 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tania Hossack Sydney, Australia More articles by this author Manish Patel Sydney, Australia More articles by this author Phillip Brenner Sydney, Australia More articles by this author Carlo Yuen Sydney, Australia More articles by this author Daniel Spernat Sydney, Australia More articles by this author Andrew Huo Sydney, Australia More articles by this author Phillip Stricker Sydney, Australia More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...