MP53-17 TRANSPERINEAL TEMPLATE PROSTATE BIOPSIES: THE NEW GOLD STANDARD FOR PROSTATE CANCER DIAGNOSIS

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening II1 Apr 2014MP53-17 TRANSPERINEAL TEMPLATE PROSTATE BIOPSIES: THE NEW GOLD STANDARD FOR PROSTATE CANCER DIAGNOSIS Shady Nafie, John Dormer, John Kilian Mellon, and Masood Ahmed Khan Shady NafieShady Nafie More articles by this author , John DormerJohn Dormer More articles by this author , John Kilian MellonJohn Kilian Mellon More articles by this author , and Masood Ahmed KhanMasood Ahmed Khan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1648AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Transrectal Ultrasound (TRUS) guided prostate biopsy is regarded as the gold standard for prostate cancer diagnosis. Transperineal template prostate biopsy (TPTPB) has been shown to improve prostate cancer detection in men with a rising PSA and previous negative TRUS guided prostate biopsies. We performed a prospective study directly comparing the prostate cancer detection rate between TRUS guided biopsy and TPTPB in 50 men with a benign feeling DRE, PSA < 20 ng/mL and no previous prostate biopsies. Methods 50 patients with a mean age of 67 years (range: 54-84), mean prostate volume of 58 cc (range:19-165) and mean PSA of 8 ng/L (range: 4-18) underwent standard 12-core TRUS guided prostate biopsy followed immediately by 36-core TPTPB under general anesthetic. We determined the prostate cancer detection rate between the two diagnostic modalities. Results A total of 20/50 (40%) men had benign pathology. Of the 30/50 (60%) diagnosed with prostate cancer 16 (32%) had positive results in both TRUS and TPTPB, while 14 (28%) had negative TRUS but positive TPTPB. Hence, TRUS guided prostate biopsy detected cancer in 32% whereas it was 60% with TPTPB. Furthermore, no cancers were detected solely by TRUS biopsy. In 19/30 (63%) the cancers detected by TPTPB had Gleason score ≥ 7. In total, 2 (4%) patients experienced urosepsis, 7 (14%) temporary urinary retention, 16 (32%) had mild haematuria and 19 (38%) haematospermia. Conclusions TPTPB is associated with a significantly higher prostate cancer detection rate compared to TRUS biopsies (60% vs. 32%, p<0.0001) in men with an elevated PSA < 20 ng/mL and a benign feeling prostate. We propose that TPTPB should be regarded as the biopsy technique of choice in this group of men. In addition, PSA appears to be a better biomarker for prostate cancer than previously thought. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e595 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Shady Nafie More articles by this author John Dormer More articles by this author John Kilian Mellon More articles by this author Masood Ahmed Khan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...