PD15-02 SPATIAL DISTRIBUTIONS OF PROSTATE CANCERS DETECTED ON REPEAT PROSTATE BIOPSIES

Abstract

You have accessJournal of UrologyProstate Cancer: Staging I1 Apr 2014PD15-02 SPATIAL DISTRIBUTIONS OF PROSTATE CANCERS DETECTED ON REPEAT PROSTATE BIOPSIES Okyaz Eminaga, Reemt Hinkelammert, Ulf Titze, Fabian Wötzel, Martin Bögemann, and Axel Semjonow Okyaz EminagaOkyaz Eminaga More articles by this author , Reemt HinkelammertReemt Hinkelammert More articles by this author , Ulf TitzeUlf Titze More articles by this author , Fabian WötzelFabian Wötzel More articles by this author , Martin BögemannMartin Bögemann More articles by this author , and Axel SemjonowAxel Semjonow More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1291AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Understanding the topographical distribution of PCa is necessary to optimise the biopsy strategy. Our aim was to identify the differences in the spatial distribution of PCa between men with a positive initial prostate biopsy (PBx) and men diagnosed with PCa at the repeat prostate biopsy (rPBx). METHODS An observational prospective study was performed in 533 consecutive men diagnosed with PCa who underwent radical prostatectomy (RPE).We evaluated prostate specimens using a cMDX-based map model of the prostate and determined the number of cancer foci, relative tumour volume, Gleason score, zone of origin, localisation, and pathologic stage after stratification according to the number of biopsy sessions (PBx vs. rPBx). The distribution of 3,966 PCa foci was analysed and visualised on heat maps. The colour gradient of the heat map was reduced to 6 colours representing the frequency classification of PCa using an image posterisation effect. RESULTS PCa diagnosed at the initial or repeat prostate biopsy was mostly concentrated in the peripheral zone of the prostate. However, the repeat biopsy PCa foci were more frequently observed in the anterior portion of the prostate compared to the foci of PCa diagnosed at the initial prostate biopsy. The most PCa foci were localised in the middle portion of the prostate in both groups of men (Initial biopsy: 48.8% vs. repeat biopsy: 46.7%). PCa mostly affected the apical half of the prostate (64.2% vs. 65.6%). When we analysed the spreading pattern of PCa on the longitudinal plane of the prostate, PCa affected both the apical and middle portions of PCa in 194 (52.2%) men with a positive initial biopsy. Of 194 men with PCa affecting the apical and middle portions of the Prostate, 16.5% of the prostate biopsy could detect PCa in both portions in one session. When we focused on the prostatectomy specimens of men with PCa diagnosed at the repeat biopsy, 46% (74) of PCa cases affected the whole parts of the prostate (apical, middle and basal). Of those, 30% of the last repeat biopsies were able to target the PC in all parts in a single session. CONCLUSIONS The spatial distribution of PCa diagnosed on repeat biopsy differs significantly from the spatial distribution of PCa diagnosed on initial biopsy. The whole anterior portion of the prostate should be assessed by repeat biopsies if PCa remains suspected after an initial negative biopsy. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e416 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Okyaz Eminaga More articles by this author Reemt Hinkelammert More articles by this author Ulf Titze More articles by this author Fabian Wötzel More articles by this author Martin Bögemann More articles by this author Axel Semjonow More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...