Decade-long insights into transperineal prostate biopsy in a west China population: Temporal trend, targeted and repeat biopsies, and pathological characterization.

Abstract

e17004 Background: Despite advances in prostate cancer (PCa) detection, the need for improving diagnostics and in-depth assessment of the latest prostate biopsy (PBx) techniques through extensive, longitudinal studies remains critical. Methods: Data from 10,378 PBx involving 10,038 patients were retrospectively examined. We detailed the yearly changes in PBx numbers and patient diagnoses, the real-world efficacy of PI-RADS scoring, MRI-targeted biopsy (MRI-TBx), and repeat PBx. We also outlined the detection rates and the clinical profiles of non-adenocarcinoma (non-AC) PCa. Results: A consistent annual increase in PBx was witnessed, with the positive rate climbing to approximately 55%. There was a gradual decline in median age, PSA levels, and M1 stage proportion among PCa patients, suggesting an earlier diagnosis trend. However, compared to Western populations, our center's patients had a significantly higher incidence of M1 stage (34% vs. 6%, P<0.001) and, within the M0 category, presented with older age and elevated baseline PSA levels. Integrating MRI-TBx into the 12-core systematic biopsy (SBx) led to a numerical improvement in PCa detection and enhanced ISUP grading accuracy. Merging MRI-TBx with a 6-core SBx achieved a median clinically significant PCa (csPCa) detection rate of 39.76% in men with PSA<20ng/mL, similar to that of MRI-TBx with a 12-core SBx (40.36%). Furthermore, we identified 1,455 men with non-AC PCa, occurring less in localized cases (about 15%) but more in metastatic cases (over 50%), and exhibiting more aggressive characteristics compared to adenocarcinoma-only cases. Besides, among the 305 individuals undergoing repeat PBx, 62 csPCa cases were identified, all of which exhibited lower positive cores, ISUP grading, and M1 stage incidence than men diagnosed by initial PBx. Conclusions: Analyzing a decade's worth of PBx data from one of the largest Asian cohorts offered pivotal insights into the evolving epidemiology and clinical profiles of PBx, which are essential for shaping future diagnostic approaches for PCa.