MP57-11 RADICAL PROSTATECTOMY PATHOLOGICAL OUTCOMES IN MEN WITH PROSTATE CANCER DIAGNOSED ON REPEAT TRANSRECTAL ULTRASOUND PROSTATE BIOPSY AFTER INITIAL HIGH RISK BENIGN PATHOLOGY

123 Background: Intraductal carcinoma of the prostate (IDC-P) is a biologically aggressive form of prostate cancer. We investigated the correlation between IDC-P in prostate biopsy samples (Pbx) and several pathological features after radical prostatectomy (RP), also its prognostic value in high-risk prostate cancer patients. Methods: Totally, 455 patients diagnosed with PCa during 2010 to 2017 in West China Hospital were included in this study. Chi-squared test and binary logistic regression were used in discovering the correlation between IDC-P and post-RP pathological features. Kaplan Meier curve, log-rank test, Cox’s proportional hazards model and C-index were applied in the investigation of the prognostic value of IDC-P on 418 high-risk patients. Results: The detection rate of IDC-P in Pbx is 7.91%. IDC-P was an independent predictor of SVI ( p= 0.014), EPE ( p< 0.001), cT stage ( p= 0.001), PSM of urethra end ( p= 0.042). Patients with IDC-P in PBx specimens manifested poorer BFS than those without IDC-P ( p< 0.001), and IDC-P pattern 2 (HR: 4.429, p= 0.020) was associated with worse prognosis than IDC-P pattern 1 (HR: 3.225, p= 0.047). Further analyses also demonstrated that the addition of IDC-P in several nomograms could improve their C-index. Conclusions: IDC-P is associated with several post-RP pathological features after radical prostatectomy. Also, IDC-P can effectively predict the patients’ BFS, and the addition of it can increase the C-index of several nomograms.

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Intraductal carcinoma of the prostate in prostate biopsy samples: correlation with aggressive pathological features after radical prostatectomy and prognostic value in high-risk prostate cancer

Asian Journal of Andrology ◽

10.4103/aja.aja_117_19 ◽

2020 ◽

Vol 22 (5) ◽

pp. 519 ◽

Cited By ~ 1

Author(s):

Peng-Fei Shen ◽

Hao Zeng ◽

Sha Zhu ◽

Jin-Ge Zhao ◽

Jun-Ru Chen ◽

...

Keyword(s):

Prostate Cancer ◽

High Risk ◽

Radical Prostatectomy ◽

Prostate Biopsy ◽

Prognostic Value ◽

Intraductal Carcinoma ◽

Pathological Features ◽

Carcinoma Of The Prostate ◽

High Risk Prostate Cancer ◽

Risk Prostate Cancer

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Prediction of pathological outcome at radical prostatectomy for MRI-ultrasound fusion prostate biopsy versus standard transrectal ultrasound guided prostate biopsy.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.6_suppl.73 ◽

2017 ◽

Vol 35 (6_suppl) ◽

pp. 73-73

Author(s):

Hans Arora ◽

Yaw A. Nyame ◽

Ahmed El-Shafei ◽

Onder Kara ◽

Andrei Purysko ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Prostate Biopsy ◽

Cleveland Clinic ◽

Transrectal Ultrasound ◽

Categorical Variables ◽

Fusion Biopsy ◽

Trus Biopsy ◽

Prostate Size ◽

Standard Template

73 Background: Magnetic resonance imaging (MRI)-ultrasound (US) fusion prostate biopsy has been shown to be able to detect prostate cancer, with the goal of targeting specific lesions. Our objective was to evaluate the ability of this technique to accurately determine the final pathological outcome at the time of radical prostatectomy as compared to standard template 12-core transrectal ultrasound (TRUS) guided prostate biopsy. Methods: We performed a retrospective analysis of patients who underwent both prostate biopsy and prostatectomy at the Cleveland Clinic. Patients who underwent standard template 12-core TRUS biopsies between January 2005 through December 2013, and MRI-US fusion biopsies from January 2014 through June 2015 were included. Patients who had more than 12 cores taken during TRUS biopsy were excluded. Relevant covariates included patient demographics as well as pre-biopsy PSA and prostate size, which were collected from the electronic medical record. Continuous variables were compared using Wilcoxon rank-sum tests and categorical variables were assessed with χ2 test. Results: In total 543 patients were included. Of these, 491 underwent 12-core standard template TRUS biopsy whereas 54 underwent MRI-US fusion biopsy. Between the two groups there were no significant differences in age (median 62 years versus 63 years, p = 0.21), race (17.5% versus 12.3 % African American, p = 0.32), family history (31.5% versus 29.3% positive, p = 0.74), prostate size (47.75g, IQR 39.5-59 versus 42.7g, IQR 37-56, p = 0.08), pre-biopsy PSA (5.2 ng/mL, IQR 4.1-7.6 versus 4.97, IQR 3.24-6.95, p = 0.14). Of the fusion biopsy patients, 14 of 54 (25.9%) were upgraded from biopsy to prostatectomy, whereas 214 of 491 (43.6%) of TRUS biopsy patients were upgraded (p = 0.02). Conclusions: Of men undergoing transrectal biopsy for the diagnosis of prostate cancer, MRI-US fusion techniques have a lower rate of upgrading at final pathology at prostatectomy as compared to standard 12-core TRUS-guided biopsy.

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11c-choline-PET/CT versus transrectal ultrasound-guided prostate biopsy to diagnose locally recurrent prostate cancer following radiation therapy.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.7_suppl.119 ◽

2011 ◽

Vol 29 (7_suppl) ◽

pp. 119-119

Author(s):

A. Heidenreich ◽

D. A. Pfister ◽

R. Epplen ◽

B. Brehmer

Keyword(s):

Prostate Cancer ◽

Radiation Therapy ◽

Radical Prostatectomy ◽

Prostate Biopsy ◽

Transrectal Ultrasound ◽

Ultrasound Guided ◽

Choline Pet ◽

Pet Ct ◽

The Mean ◽

Locally Recurrent

119 Background: Radical salvage prostatectomy (SRP) represents one local secondary treatment option with curative intent in patients failing radiation therapy (RT) for localized prostate cancer (PCA). 11C-PET/CT represents an innovative imaging study to detect systemic spread of prostate cancer. However, there is only limited experience with regard to the sensitivity of C-PET/CT to detect locally recurrent PCA following radiation therapy. The purpose of our study was to analyse the sensitivity of C-PET/CT to diagnose PCA and extra- and intraprostatic extension. Methods: 45 patients with the suspicion of locally recurrent PCA underwent 12-core transrectal ultrasound- guided biopsy of the prostate, C-PET/CT, bonne scan and radical salvage prostatectomy. Findings of the imaging studies were correlated with the pathohistological findings of the prostate biopsy and the radical prostatectomy specimen. All prostatectomy specimens were proceeded according to the Stanford protocol and the number and location of intraprostatic cancer foci > 5mm were correlated with the PE/CT findings. Results: The mean preoperative serum PSA was 7.8 (2–24) ng/ml; the mean biopsy Gleason Score was 5.6 (4–9). Prostate biopsy was positive in 37/45 (82.2%) patients whereas 8/45 (17.8%) had a negative biopsy despite positive PET/CT findings. PET/CT was positive in 45/45 patients. Radical prostatectomy specimens identified locally recurrent PCA in 44/45 (97.8%). One patient turned out to have pT0pN0 disease despite increasing PSA. PET/CT identified 1, 2, and > 2 intraprostatic cancer foci of significant volume in 23 (51.1%), 13 (28.9%) and 9 (20%) patients, respectively. Sensitivity to detect intraprostatic, histologically proven PCA foci is 95.6% which is significantly superior to the biopsy results. There was a high correlation between the PET/CT results and the final histology of the radical prostatectomy specimens. Conclusions: Choline PET/CT is an innovative imaging to identify patients with locally recurrent PCA following radiation therapy. PET/CT is superior to prostate biopsy and we recommend a PET/CT in patients who are candidates for radical salvage prostatectomy. No significant financial relationships to disclose.

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