The Comparison of Imaging and Clinical Methods to Estimate Prostate Volume: A Single-Centre Retrospective Study

2021 ◽  
pp. 1-7
Author(s):  
Matteo Massanova ◽  
Sophie Robertson ◽  
Biagio Barone ◽  
Lorenzo Dutto ◽  
Vincenzo Francesco Caputo ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Prostate Volume ◽  
Transrectal Ultrasound ◽  
Digital Rectal Examination ◽  
Benign Prostatic Hypertrophy ◽  
Volume Measurement ◽  
Surgical Specimen ◽  
Significant Difference ◽  
Ellipsoid Volume

<b><i>Background:</i></b> Prostate volume (PV) is a useful tool in risk stratification, diagnosis, and follow-up of numerous prostatic diseases including prostate cancer and benign prostatic hypertrophy. There is currently no accepted ideal PV measurement method. <b><i>Objective:</i></b> This study compares multiple means of PV estimation, including digital rectal examination (DRE), transrectal ultrasound (TRUS), and magnetic resonance imaging (MRI), and radical prostatectomy specimens to determine the best volume measurement style. <b><i>Methods:</i></b> A retrospective, observational, single-site study with patients identified using an institutional database was performed. A total of 197 patients who underwent robot-assisted radical prostatectomy were considered. Data collected included age, serum PSA at the time of the prostate biopsy, clinical T stage, Gleason score, and PVs for each of the following methods: DRE, TRUS, MRI, and surgical specimen weight (SPW) and volume. <b><i>Results:</i></b> A paired <i>t</i> test was performed, which reported a statistically significant difference between PV measures (DRE, TRUS, MRI ellipsoid, MRI bullet, SP ellipsoid, and SP bullet) and the actual prostate weight. Lowest differences were reported for SP ellipsoid volume (<i>M</i> = −2.37; standard deviation [SD] = 10.227; <i>t</i>[167] = −3.011; and <i>p</i> = 0.003), MRI ellipsoid volume (<i>M</i> = −4.318; SD = 9.53; <i>t</i>[167] = −5.87; and <i>p</i> = 0.000), and MRI bullet volume (<i>M</i> = 5.31; SD = 10.77; <i>t</i>[167] = 6.387; and <i>p</i> = 0.000). <b><i>Conclusion:</i></b> The PV obtained by MRI has proven to correlate with the PV obtained via auto-segmentation software as well as actual SPW, while also being more cost-effective and time-efficient. Therefore, demonstrating that MRI estimated the PV is an adequate method for use in clinical practice for therapeutic planning and patient follow-up.

scholarly journals Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a multi-institutional comparative study

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Amr A. Faddan ◽  
Mahmoud M. Shalaby ◽  
Mohamed Gadelmoula ◽  
Younis Alshamsi ◽  
Daniar K. Osmonov ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Complication Rate ◽  
Perioperative Complications ◽  
Statistical Significance ◽  
Operating Time ◽  
Perioperative Outcomes ◽  
Academic Institutions ◽  
Robot Assisted ◽  
Surgical Specimen ◽  
Significant Difference

Abstract Background The standard surgical treatment of localized prostate cancer (PCa) has been rapidly changed along the last two decades from open to laparoscopic and finally robot-assisted techniques. Herein, we compare the three procedures for radical prostatectomy (RP), namely radical retropubic (RRP), laparoscopic (LRP), and robot-assisted laparoscopic (RALRP) regarding the perioperative clinical outcome and complication rate in four academic institutions. Methods A total of 394 patients underwent RP between January 2016 and December 2018 in four academic institutions; their records were reviewed. We recorded the patient age, BMI, PSA level, Gleason score and TNM stage, type of surgery, the pathological data from the surgical specimen, the perioperative complications, unplanned reoperating, and readmission rates within 3 months postoperatively. Statistical significance was set at (P < 0.05). All reported P values are two-sided. Results A total of 123 patients underwent RALRP, 220 patients underwent RRP, and 51 underwent LRP. There was no statistically significant difference between the three groups regarding age, BMI, prostatic volume, and preoperative PSA. However, there were statistically significant differences between them regarding the operating time (P < .0001), catheterization period (P < .001), hospital stay (P < .0001), and overall complications rate (P = .023). Conclusions The minimally invasive procedures (RALRP and LRP) are followed by a significantly lower complication rate. However, the patients’ factors and surgical experience likely impact perioperative outcomes and complications.

Prostate volume measurement by transrectal ultrasound and computed tomography before and after permanent prostate brachytherapy

2004 ◽  
Vol 60 (3) ◽  
pp. 767-776 ◽  
Author(s):  
Matthew C. Solhjem ◽  
Brian J. Davis ◽  
Thomas M. Pisansky ◽  
Torrence M. Wilson ◽  
Lance A. Mynderse ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Prostate Volume ◽  
Transrectal Ultrasound ◽  
Volume Measurement ◽  
Prostate Brachytherapy ◽  
Before And After

scholarly journals Health-Related Quality of Life following Cytoreductive Radical Prostatectomy in Patients with de-novo Oligometastatic Prostate Cancer

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5636
Author(s):  
Michael Chaloupka ◽  
Lina Stoermer ◽  
Maria Apfelbeck ◽  
Alexander Buchner ◽  
Vera Wenter ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
De Novo ◽  
Health Related Quality ◽  
Significant Difference ◽  
Related Quality ◽  
Health Related

(1) Background: local treatment of the primary tumor has become a valid therapeutic option in de-novo oligo-metastatic prostate cancer (PC). However, evidence regarding radical prostatectomy (RP) in this setting is still subpar, and the effect of cytoreductive RP on postoperative health-related quality of life (HRQOL) is still unclear. (2) Methods: for the current study, patients with de-novo oligo-metastatic PC (cM1-oligo), defined as ≤5 bone lesions in the preoperative staging, were included, and matched cohorts using the variables age, body-mass index (BMI), and pT-stage were generated. Patient-reported outcome measures (PROMS) were assessed pre- and postoperatively using the validated EORTC-QLQ-C30, IIEF-5, and ICIQ-SF questionnaires. The primary endpoint for univariate and multivariable analysis was good general HRQOL defined by previously validated cut-off values. (3) Results: in total, 1268 patients (n = 84 (7%) cM1-oligo) underwent RP between 2012 and 2020 at one tertiary care center. A matched cohort of 411 patients (n = 79 with oligo-metastatic bone disease (cM1-oligo) and n = 332 patients without clinical indication of metastatic disease (cM0)) was created. The median follow-up was 25mo. There was no significant difference in good general HRQOL rates between cM1-oligo-patients and cM0-patients before RP (45.6% vs. 55.2%, p = 0.186), and at time of follow-up (44% vs. 56%, p = 0.811). Global health status (GHS) worsened significantly in cM0-patients compared to baseline (−5, p = 0.001), whereas GHS did not change significantly in cM1-oligo-patients (+3.2, p = 0.381). In multivariate analysis stratified for good erectile function (IIEF5 > 18; OR 5.722, 95% CI 1.89–17.36, p = 0.002) and continence recovery (OR 1.671, 95% CI 1.03–2.70, p = 0.036), cM1-oligo was not an independent predictive feature for general HRQOL (OR 0.821, 95% CI 0.44–1.53, p = 0.536). (4) Conclusions: in this large contemporary retrospective analysis, we observed no significant difference in HRQOL in patients with the oligometastatic bone disease after cytoreductive radical prostatectomy, when compared to patients with localized disease at time of surgery.

scholarly journals Factors Related to Biochemical Relapse in Patients Undergoing Radical Prostatectomy with Lymphadenectomy.

2019 ◽  
Vol 2 (1) ◽  
pp. 01-04
Author(s):  
Grimar de Oliveira Paula ◽  
João Emerson de Alencar Santos ◽  
Luiz Carlos de Araújo Souza
Keyword(s):  
Radical Prostatectomy ◽  
Gleason Score ◽  
Clinical Stage ◽  
Surgical Specimen ◽  
Pathological Staging ◽  
Bcr Method ◽  
Transrectal Prostate Biopsy ◽  
Age Range

Objectives - Analyze the prevalence of biochemical recurrence (BCR) in patients submitted to radical prostatectomy with lymphadenectomy (RP-LD) the most prevalent clinical and pathological staging in the BCR and to correlate the sum of the Gleason score (GS) in the surgical specimen in patients who presented BCR. Method - Analysis of 100 patients diagnosed with prostate adenocarcinoma who performed RP-LD between 2013 to 2017. All subjects underwent transrectal prostate biopsy due to PSA or rectal examination and RP-LD. The lymphadenectomy considered in the study was the iliac-obturator, and the surgical pieces were analyzed to determine the pathological staging and its descriptors. All patients who had two or more PSA measurements >0.2 ng/ml and who had undergone RP-LD were considered postoperative. Results -About 22% of the patients submitted to RP-LD presented BCR. Patients with BCR had a 59-76 age range, mean age of 66.27 years, and median age of 63.50 years. The most prevalent preoperative PSA in patients with BCR was between 10-20 ng/ml (40.90%) and the most prevalent clinical stage was cT2 (59.10%). Regarding the Gleason score, the BCR patients had the most prevalent 6 (36.37%) score in the biopsy and score 7 (4 + 3) (36.37%) in the surgical specimen. All patients (100%) with BCR presented perineural invasion, with pT3 staging (81.81%) and pN0 (77.28%) being the most prevalent in patients with BCR. Patients with BCR presented a correlation (p<0.05) between the increase in the sum of pathological GS and the increase in pTN staging. Conclusion - All these variables were important in the determination of BCR in patients submitted to RP-LD, thus demonstrating the importance of this information in the analysis of the prognosis and in the follow-up of these patients.

Effect of alpha-blocker use on morbidity and lower urinary tract symptoms in patients undergoing transrectal ultrasound-guided prostate biopsy

2021 ◽  
pp. 039156032110383
Author(s):  
Remzi Salar ◽  
Güven Erbay
Keyword(s):  
Prostate Biopsy ◽  
Voiding Dysfunction ◽  
Prostate Volume ◽  
Transrectal Ultrasound ◽  
Urine Volume ◽  
Maximum Flow ◽  
Control Group ◽  
Alpha Blocker ◽  
Urinary Tract Symptoms ◽  
Significant Difference

Objective: To evaluate voiding dysfunction and morbidity after transrectal ultrasound (TRUS)-guided prostate biopsy and to investigate whether pre-intervention alpha-blocker treatment had any effect on morbidity and voiding dysfunction. Material and methods: The study included 197 consecutive patients who underwent TRUS-guided prostate biopsy between January 2014 and January 2018. The patients were divided into two groups, those receiving alpha-blocker (silodosin) and those not receiving alpha-blocker treatment before the procedure (controls). All patients were evaluated before and one week after the procedure with the International Prostate Symptom Score (IPSS), measurements of maximum flow rate ( Qmax), post-void residual urine volume (PVR) and prostate volume, and procedure-related complications were also recorded. All analyzed parameters were compared by within-group and between-group evaluations. Results: There was no significant difference between the two groups in terms of IPSS, Qmax and prostate volume values before biopsy. In the follow-up evaluation performed on the seventh day after biopsy, IPSS, PVR and prostate volume were found to be increased, whereas Qmax was decreased in the control group ( p < 0.05). In the silodosin group, an increase in prostate volume was observed, but there were no significant changes in IPSS, Qmax and PVR values. Acute urinary retention (AUR) after the biopsy procedure developed in two patients (2%) in the silodosin group, and in nine patients (9.1%) in the control group ( p = 0.02). No significant difference was found between the two groups in terms of biopsy-related complications, except for AUR. Conclusion: We believe that alpha-blocker treatment initiated before biopsy may be advantageous in preventing voiding dysfunction that may develop after the procedure.

Characteristics and Oncological Outcome of Clinical T3a Prostate Cancer Patients Undergoing Radical Prostatectomy in the Multi-Parametric MRI Era

2020 ◽  
Author(s):  
Kasumi Yoshitomi ◽  
Shinya Yamamoto ◽  
Tatsuya Yamamoto ◽  
Eri Fukagawa ◽  
Kosuke Hamada ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Survival Rate ◽  
Radical Prostatectomy ◽  
Cancer Patients ◽  
Digital Rectal Examination ◽  
Oncological Outcome ◽  
Risk Groups ◽  
Free Survival ◽  
Significant Difference ◽  
Preoperative Factors

Abstract We aimed to reveal the association between the method of diagnosis (multi-parametric magnetic resonance imaging [mpMRI] and digital rectal examination [DRE]) and oncological outcomes of patients with clinical T3a (cT3a) prostate cancer after radical prostatectomy (RP) and stratify them according to oncological risk. We included 132 cT3a prostate cancer patients who underwent RP between 2008 and 2018. The biochemical recurrence (BCR)-free survival rate was evaluated according to the method of diagnosis (mpMRI alone; mpMRI group vs. DRE [with or without mpMRI]; DRE group). Several preoperative factors were evaluated in the multivariate analysis. Patients were divided into risk groups by our prediction model. The mpMRI group had significantly longer BCR-free survival than the DRE group (p<0.0001). The method of diagnosis (hazard ratio [HR]=2.69; 95% confidence interval [CI] 1.45-5.06; p=0.0017) and % positive cores (HR=4.36; 95% CI 1.14-16.5; p=0.031) were independent prognostic factors. Patients were divided into three risk groups based on these factors. There was a significant difference in BCR-free survival rate among the groups (p=0.0002).The method of diagnosis of cT3a prostate cancer was associated with BCR-free survival, and we categorized patients into risk groups. These assessments were attributable to the appropriate therapeutic strategy for patients with cT3a prostate cancer.

scholarly journals Prostate Volume Measurement by TRUS Using Heights Obtained by Transaxial and Midsagittal Scanning: Comparison with Specimen Volume Following Radical Prostatectomy

2000 ◽  
Vol 1 (2) ◽  
pp. 110 ◽  
Author(s):  
Sung Bin Park ◽  
Jae Kyun Kim ◽  
Sung Hoon Choi ◽  
Han Na Noh ◽  
Eun Kyung Ji ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Prostate Volume ◽  
Volume Measurement ◽  
Specimen Volume

Is routine prostate biopsy needed prior to radical cystectomy?

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 223-223
Author(s):  
Yasuhiro Hashimoto ◽  
Yuichiro Suzuki ◽  
Atsushi Imai ◽  
Akiko Okamoto ◽  
Hayato Yamamoto ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Digital Rectal Examination ◽  
Invasive Bladder Cancer ◽  
Negative Group ◽  
Group I

223 Background: Prostate cancer (Pca) can be detected coincidentally in radical cystoprostatectomy (RCP) specimens for invasive bladder cancer. However, there is no uniformity of opinion on the need for prostate biopsy prior to RCP. We evaluated the necessity of preoperative prostate biopsy in invasive bladder cancer. Methods: From 1998 through 2009, of 300 patients undergoing radical cystectomy for muscle-invasive bladder cancer, 252 were male. Of these, we focused 212 patients, whose prostate-specific antigen (PSA) was measured preoperatively. Results: The median age was 66years and median follow-up period was 46 months. Thirty-five patients with PSA > 4.0 ng/mL or digital rectal examination (DRE) positive were all subjected to transrectal ultrasound (TRUS)-guided prostate biopsy (Pbx), and Pca was detected in 7 cases (20%) (Group I). Pca was also detected in 5 patients (17.9%) in RCP specimens of the 28 whose Pbx results were negative (Group II). Seventy-seven of the 177 patients with PSA ≤ 4.0ng/mL and DRE negative were underwent TRUS-guided Pbx, and Pca was detected in 1 case (1.3%) (Group III). Pca was detected in 10 patients (13.2%) out of the 76 whose Pbx results were negative (Group IV). Of the 177 patients, 100 underwent RCP without prostate biopsy, and Pca was detected in 16 cases (16%) (Group V). The average Gleason score of each Group, I, II, III, IV, and V were 6.6, 6.6, 7, 6.2, and 6.5, respectively. Tumor volumes of each Group, I, II, III, IV, and V were 3.12mL, 1.0mL, 0.65mL, 0.43mL, and 0.19mL, respectively. No patients experienced recurrence of PC, including biochemical recurrence. Conclusions: In cases with PSA ≤4.0 ng/mL and/or DRE negative, Pbx is not considered necessary. In cases with PSA > 4.0 ng/mL or DRE positive, Pca with an average volume of 3.12 mL were detected by Pbx in 20% of the patients. However, most are localized Pca, and postoperative recurrence of the Pca is not seen during follow-up period. The question of whether all patients in this group require Pbx needs to be examined through further stratification.

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