scholarly journals Tumor-Associated Release of Prostatic Cells into the Blood after Transrectal Ultrasound-Guided Biopsy in Patients with Histologically Confirmed Prostate Cancer

2019 ◽  
Vol 66 (1) ◽  
pp. 161-168 ◽  
Author(s):  
Simon A Joosse ◽  
Burkhard Beyer ◽  
Christin Gasch ◽  
Paulina Nastały ◽  
Andra Kuske ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Tumor Cells ◽  
Prostate Biopsy ◽  
Standard Procedure ◽  
Multivariable Analysis ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Ultrasound Guided ◽  
Systemic Spread

Abstract BACKGROUND Transrectal ultrasound-guided prostate biopsy (TRUS) is a standard procedure for prostate cancer diagnosis. Because prostate cancer is a multifocal disease in many patients, multiple sampling (n ≥ 10) is required, which may bear the risk of systemic spread of cancer cells. DESIGN Using the standardized CellSearch® system that allows for the detection of single epithelial cell adhesion molecule-positive circulating tumor cells (CTCs) in blood, we investigated whether prostate biopsy is associated with release of prostatic tumor cells into the circulation. Peripheral blood was obtained before and within 30 min after performing prostate biopsy from 115 men with increased serum prostate-specific antigen. RESULTS The number of CTCs significantly increased after biopsy in men with histologically confirmed prostate cancer (odds ratio, 7.8; 95% CI, 4.8–12.8), whereas no biopsy-related changes could be detected in men without confirmed prostate cancer. Multivariable analysis showed that biopsy-related increase of CTCs was significantly correlated with a worse progression-free survival (hazard ratio, 12.4; 95% CI, 3.2–48.6) within the median follow-up of 41 months. CONCLUSIONS Prostate biopsies may lead to a tumor-associated release of CTCs into the blood circulation. Larger confirmatory trials with longer follow-up periods are required before any change in clinical practice can be recommended.

scholarly journals The Management of the Patient with Elevated Prostate Specific Antigen and a Negative Initial Prostate Biopsy

2015 ◽  
Vol 61 (1) ◽  
pp. 7-9
Author(s):  
A.O. Vida ◽  
A. Szöllősi ◽  
A. Maier ◽  
B.M. Boja ◽  
Mártha Orsolya
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Vital Role ◽  
Ultrasound Guided ◽  
Atypical Small Acinar Proliferation ◽  
Initial Biopsy ◽  
Histopathological Result

Abstract Background: The prostate cancer (PCa) is the second most common cancer amongst men. An elevated prostate specific antigen (PSA) level can lead to PCa suspition, thus the confirmation has to be a histopathological one. However, not all increased PSA level means prostate cancer. Material and Method: This retrospective study presents the results of 422 ultrasound guided prostate biopsy (PB) performed at the Clinic of Urology Târgu- Mureş, between 2011-2012. Inclusion criteria: patients with at least one negative PB and an elevated value of PSA. Results: In a two year period, from the total of 422 PB (100%), in 179 (42.42%) patients the histopathological result was “negative”. In 154 (86%) of cases ultrasound guided biopsies were performed, mostly with an initial 6 core (98- 54.74% of patients). Average PSA level was 13.45 ng/ml (0.49-100 ng/ml), the histological findings confirmed PCa in 52.58% cases, normal prostatic tissue in 141 cases (78.77%), atypical small acinar proliferation in 12 patients (6.70%), prostate atrophy in 11 males (6.14%), benign prostatic hyperplasia in 10 cases (5.59%) and prostatitis in 5 cases (2.80%). In 30 cases (16.75%) rebiopsy was performed with a number of 10- 12 cores. Conclusions: In order to increase PCa detection we should perform more cores during PB. In „negative” histopathological cases PSA should be monitorised and the biopsy should be repeated after 6 to 8 weeks from the initial biopsy. Patient’s compliance plays a vital role in the follow-up of the procedure

One-year experience of government-funded magnetic resonance imaging prior to prostate biopsy: A case for omitting biopsy in men with a negative magnetic resonance imaging

2021 ◽  
pp. 205141582110043
Author(s):  
Hanna J El-Khoury ◽  
Niranjan J Sathianathen ◽  
Yuxin Jiao ◽  
Reza Farzan ◽  
Dennis Gyomber ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Prostate Biopsy ◽  
Multivariable Analysis ◽  
Transrectal Ultrasound ◽  
Resonance Imaging ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Clinically Significant

Objectives: This study aimed to characterise the accuracy of multiparametric magnetic resonance imaging (mpMRI) as an adjunct to prostate biopsy, and to assess the effect of the new Australian Medicare rebate on practice at a metropolitan public hospital. Patients and methods: We identified patients who underwent transrectal ultrasound (TRUS)-guided prostate biopsy at a single institution over a two-year period. Patients were placed into two groups, depending upon whether their consent was obtained before or after the introduction of the Australian Medicare rebate for mpMRI. We extracted data on mpMRI results and TRUS-guided biopsy histopathology. Descriptive statistics were used to demonstrate baseline patient characteristics as well as MRI and histopathology results. Results: A total of 252 patients were included for analysis, of whom 128 underwent biopsy following the introduction of the Medicare rebate for mpMRI. There was a significant association between Prostate Imaging Reporting and Data System v2 (PI-RADS) classification and the diagnosis of clinically significant prostate cancer ( p<0.01). Only one man with PI-RADS ⩽2 was found to have clinically significant prostate cancer. Four men with a PI-RADS 3 lesion were found to have clinically significant cancer. A PI-RADS 4 or 5 lesion was significantly associated with the diagnosis of clinically significant cancer on multivariable analysis. Conclusion: mpMRI is an important adjunct to biopsy in the diagnosis of clinically significant prostate cancer. Our findings support the safety of omitting/delaying prostate biopsy in men with negative mpMRI. Level of evidence: Level 3 retrospective case-control study.

scholarly journals Predictors of Gleason score upgrading in patients with prostate biopsy Gleason score ≤6

2014 ◽  
Vol 8 (5-6) ◽  
pp. 342 ◽  
Author(s):  
Hasmet Sarici ◽  
Onur Telli ◽  
Orhan Yigitbasi ◽  
Musa Ekici ◽  
Berat Cem Ozgur ◽  
...  
Keyword(s):  
Gleason Score ◽  
Prostate Biopsy ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Radical Retropubic Prostatectomy ◽  
Small Sample ◽  
Ultrasound Guided ◽  
Increased Risk ◽  
Biopsy Gleason Score

Introduction: The discrepancy between prostate biopsy and prostatectomy Gleason scores is common. We investigate the predictive value of prostate biopsy features for predicting Gleason score (GS) upgrading in patients with biopsy Gleason scores ≤6 who underwent radical retropubic prostatectomy (RRP). Our aim was to determine predictors of GS upgrading and to offer guidance to clinicians in determining the therapeutic option.Methods: We performed a retrospective study of patients who underwent RRP for clinically localized prostate cancer at 2 major centres between January 2007 and March 2013. All patients with either abnormal digital examination or elevated prostate-specific antigen at screening underwent transrectal ultrasound-guided prostate biopsy. Variables were evaluated among the patients with and without GS upgrading. Our study limitations include its retrospective design, the fact that all subjects were Turkish and the fact that we had a small sample size.Results: In total, 321 men had GS ≤6 on prostate biopsy. Of these, 190 (59.2%) had GS ≤6 concordance and 131 (40.8%) had GS upgrading from ≤6 on biopsy to 7 or higher at the time of the prostatectomy. Independent predictors of pathological upgrading were prostate volume <40 cc (p < 0.001), maximum percent of cancer in any core (p = 0.011), and >1 core positive for cancer (p < 0.001).Conclusions: When obtaining an extended-core biopsy scheme, patients with small prostates (≤40 cc), greater than 1 core positive for cancer, and an increased burden of cancer are associated with increased risk of GS upgrading. Patients with GS ≤6 on biopsy with these pathological parameters should be carefully counselled on treatment decisions.

NOMOGRAM TO PREDICT PROSTATE CANCER DIAGNOSIS ON TRANSRECTAL ULTRASOUND-GUIDED PROSTATE BIOPSY IN A CONTEMPORARY SERIES

2008 ◽  
Vol 179 (4S) ◽  
pp. 643-644
Author(s):  
Christopher J DiBlasio ◽  
Michael M Maddox ◽  
Reza Mehrazin ◽  
John B Malcolm ◽  
Michael A Aleman ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Diagnosis ◽  
Prostate Biopsy ◽  
Transrectal Ultrasound ◽  
Ultrasound Guided ◽  
Prostate Cancer Diagnosis

Malakoplakia prostate presenting as urinary retention: a report of two cases and review of the literature

2021 ◽  
Vol 14 (7) ◽  
pp. e243927
Author(s):  
Swaroop Subbaraya ◽  
Ajit Sawant ◽  
Prakash Pawar ◽  
Sunil Patil
Keyword(s):  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Transurethral Resection Of Prostate ◽  
Review Of The Literature ◽  
Ultrasound Guided ◽  
Prostatic Biopsy ◽  
Chronic Inflammatory Condition

Malakoplakia is a rare chronic inflammatory condition, which primarily occurs in genitourinary tract, with prostatic malakoplakia being extremely rare. We present two cases of acute urinary retention, with clinically firm nodular prostate and a raised serum prostate-specific antigen. Transrectal ultrasound-guided prostatic biopsy showed features of malakoplakia. There was a significant reduction of size of prostate on transrectal ultrasonography after 4 weeks of antibiotics. However, one patient had failed trial without catheter and was subjected to transurethral resection of prostate. The biopsy of the prostatic chips also showed features of malakoplakia. Other patient improved symptomatically after antibiotics and was managed conservatively. Both the patients are on regular follow-up and are asymptomatic. Prostatic malakoplakia presenting as urinary retention is very uncommon with around 12 cases in the literature. Recognition of prostatic malakoplakia is important because clinically it can masquerade prostatic malignancy. Treatment with antibiotics is necessary before subjecting the patients for surgery in patients with obstructive symptoms.

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