scholarly journals Predicting the Gleason sum of a patient with a prostate biopsy core Gleason ≤7 and a prostate biopsy core Gleason ≥8

2014 ◽  
Vol 8 (7-8) ◽  
pp. 476
Author(s):  
Olivier P. Heimrath ◽  
Zuzana Kos ◽  
Eric C. Belanger ◽  
Ilias Cagiannos ◽  
Chris Morash ◽  
...  
Keyword(s):  
Relative Risk ◽  
Radical Prostatectomy ◽  
Prostate Specific Antigen ◽  
Prostate Biopsy ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Inclusion Criteria ◽  
Ottawa Hospital ◽  
Biopsy Core ◽  
Risk Categories

Introduction: We review a subset of men who had discordant prostate biopsy sums and were treated with radical prostatectomy.Methods: Consecutive patients treated with radical prostatectomy at The Ottawa Hospital between 2000 and 2012 were reviewed. Those with at least 1 prostate biopsy core of Gleason sum ≥8 and at least 1 prostate biopsy core of Gleason sum ≤7 cancer were included.Results: Of the 764 radical prostatectomies, 661 (87%) were eligible for the study and 35 (5%) met inclusion criteria. Of these, only 16 (46%) had prostatectomy Gleason sum of ≥8. When the highest biopsy core was Gleason sum 8 (n = 24), only 7 (29%) had a prostatectomy Gleason sum ≥8. When the highest biopsy core was Gleason 9 (n = 11), 9 (82%) had a prostatectomy Gleason sum ≥8 (relative risk [RR] 2.8; p = 0.004). Patients with clinical T3 tumours were at higher risk of Gleason sum ≥8 compared to cT1 patients (RR 3.7; p = 0.008). Patient age (p = 0.89), preoperative prostate-specific antigen (p = 0.34), prostate volume (p = 0.86), number of biopsy cores (p = 0.18), and proportion of biopsy cores with cancer (p = 0.96) were not strongly associated with risk of prostatectomy Gleason sum ≥8.Conclusion: These data should be considered when assigning patients into prognostic risk categories based on prostate biopsy information. Further study to verify our findings using larger samples is warranted.

Impact of prostate needle biopsy on erectile function: A prospective study

2019 ◽  
Vol 86 (3) ◽  
pp. 145-147
Author(s):  
Koosha Kamali ◽  
Mostafa Nabizadeh ◽  
Mojtaba Ameli ◽  
Maryam Emami ◽  
Mohadese Mahvari-Habibabadi ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Prostate Specific Antigen ◽  
Prostate Biopsy ◽  
Needle Biopsy ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Prostate Specific Antigen Level ◽  
Antigen Level ◽  
Ultrasound Guided ◽  
The Mean

Background: Needle biopsy of the prostate is a diagnostic method for prostate cancer which is a relatively safe method with low risk of serious complications. The evidences regarding the occurrence of erectile dysfunction following prostate biopsy are controversial. Herein, we aimed at determining the rate of erectile dysfunction in those undergoing transrectal ultrasound-guided prostate biopsy. Method: All candidates for prostate biopsy were enrolled. The International Index of Erectile Function-5 was completed 1 m before and 1, 3, and 6 months after ultrasound-guided prostate biopsy by each patient for erectile dysfunction. Patients with a previous history of erectile dysfunction which due to a positive pathology had received any type of treatment were excluded from the study. Results: Eighty patients with the mean age of 64.8 years, the mean prostate-specific antigen level of 11.64 ng/dL, and the mean prostate volume of 62.43 cc were included. The prostate biopsy result was positive in 38.8% of the cases. No significant relationship was found between erectile dysfunction and prostate-specific antigen level, prostate volume, and the pathology result (P = 0.320, 0.509, and 0.131). The mean questionnaire score 1 month before and after the biopsy was 23 and 18, respectively; it demonstrated a significant difference (P < 0.001). The same score was 17 and 14.5 three and six months after biopsy. The mean score 1 m before and 3 m after biopsy also revealed a significant difference (P < 0.001). Conclusion: Transrectal ultrasound-guided needle biopsy of the prostate causes progressive erectile dysfunction in these patients. This relationship is not affected by the biopsy result, prostate volume, or the prostate-specific antigen level.

Serum proPSA as a marker for reducing repeated prostate biopsy numbers

2017 ◽  
Vol 42 (1) ◽  
Author(s):  
Sema Nur Ayyıldız ◽  
Tevfik Noyan ◽  
Ali Ayyıldız ◽  
Erdal Benli ◽  
Abdullah Çırakoğlu ◽  
...  
Keyword(s):  
Prostate Specific Antigen ◽  
Prostate Biopsy ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Lower Sensitivity ◽  
Health Index ◽  
Prostate Biopsies ◽  
Prostate Health Index ◽  
Total Psa ◽  
Prostate Health

AbstractIntroduction:Prostate specific antigen (PSA) has a lower sensitivity and specifity range of 4–10 ng/mL. We aimed to investigate the effectiveness of pPSA in reducing number of prostate biopsies.Methods:This study enrolled 80 patients aged 50 years or older whom had serum total PSA levels between 4 ng/dL and 10 ng/dL. Age, prostate volume, tPSA, fPSA, pPSA, PSA%, pPSA%, t/pPSA, f/pPSA, p/fPSA, p/tPSA, f/p/tPSA, p/f/tPSA, PSAD, fPSA/PSAD, pPSA/PSAD, (Prostate Health Index) PHI, (t/f/pPSA)/tPSA, and PHI2 (New Prostate Health Index) biopsy results were compared between subjects BPH and PCa.Results:Out of 80 subjects, 23 (29%) had PCa and 57 (71%) had BPH. Prostate volume was 51.65 mL in PCa and 64.85 mL in non-PCa group (p>0.05). The rate of PCa increased as prostate volume was reduced and age increased. fPSA, PSA%, p/f/tPSA, fPSA/PSAD values were significant in favor of respectively; BPH, BPH, PCa and BPH (p<0.05).Discussion:Using prostate health index (PHI) was beneficial for predicting PCa. In addition, using pPSA in formulas such as (PHI2) pPSA/(fPSA*√tPSA), p/f/tPSA, (t/f/pPSA)/tPSA may also be useful. This study suggests that the use of pPSA may have a role in reducing the number of prostate biopsies in differentiating PCa and BPH.

scholarly journals The use of prostate specific antigen density to predict clinically significant prostate cancer

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Igor Yusim ◽  
Muhammad Krenawi ◽  
Elad Mazor ◽  
Victor Novack ◽  
Nicola J. Mabjeesh
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Prostate Biopsy ◽  
Prostate Volume ◽  
Characteristic Curve ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Prostate Adenocarcinoma ◽  
Prostate Specific Antigen Density ◽  
Clinically Significant

AbstractThe purpose of this study was to assess the predictive value of prostate specific antigen density (PSAD) for detection of clinically significant prostate cancer in men undergoing systematic transrectal ultrasound (TRUS)-guided prostate biopsy. We retrospectively analyzed data of men who underwent TRUS-guided prostate biopsy because of elevated PSA (≤ 20 ng/ml) or abnormal digital rectal examination. Receiver operating characteristic curve analysis to compare PSA and PSAD performance and chi-square automatic interaction detector methodologies were used to identify predictors of clinically significant cancer (Gleason score ≥ 7 or international society of urological pathology grade group ≥ 2). Nine-hundred and ninety-two consecutive men with a median age of 66 years (IQR 61–71) were included in the study. Median PSAD was 0.10 ng/ml2 (IQR 0.10–0.22). Prostate adenocarcinoma was diagnosed in 338 men (34%). Clinically significant prostate adenocarcinoma was diagnosed in 167 patients (50% of all cancers and 17% of the whole cohort). The AUC to predict clinically significant prostate cancer was 0.64 for PSA and 0.78 for PSAD (P < 0.001). The highest Youden's index for PSAD was at 0.20 ng/ml2 with 70% sensitivity and 79% specificity for the diagnosis of clinically significant cancer. Men with PSAD < 0.09 ng/ml2 had only 4% chance of having clinically significant disease. The detection rate of clinically significant prostate cancer in patients with PSAD between 0.09 and 0.19 ng/ml2 was significantly higher when prostate volume was less than 33 ml. In conclusion, PSAD was a better predictor than PSA alone of clinically significant prostate cancer in patients undergoing TRUS-guided biopsy. Patients with PSAD below 0.09 ng/ml2 were unlikely to harbor clinically significant prostate cancer. Combining PSAD in the gray zone (0.09–0.19) with prostate volume below 33 ml adds diagnostic value of clinically significant prostate cancer.

scholarly journals Age, prostate volume, prostate-specific antigen and prostate-specific antigen density as predictor factors in results of transrectal ultrasonography-guided prostate biopsy

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 875
Author(s):  
Prima Ciko Ade Putra ◽  
Rainy Umbas ◽  
Agus Rizal Ardy Hariandy Hamid ◽  
Chaidir Arif Mochtar
Keyword(s):  
Prostate Specific Antigen ◽  
Prostate Biopsy ◽  
Roc Curve ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Transrectal Ultrasonography ◽  
Negative Group ◽  
Biopsy Result ◽  
Positive Biopsy ◽  
Predictor Factors

Background: To identify the predictor factors, such as prostate-specific antigen (PSA), age, prostate volume (PV), and PSA density (PSAD) as indications to perform transrectal ultrasonography (TRUS)-guided prostate biopsy in reducing unnecessary biopsies and improving detection rate. Methods: A total of 1232 samples were obtained from the medical records of patients underwent prostate biopsy from January 2008 to December 2013 in Cipto Mangunkusumo Hospital Jakarta. Pre-biopsy data including age, PSA, prostate volume, and PSAD were obtained. The Mann-Whitney U-test and unpaired t-test were conducted on the quantitative variables; a chi-square test was used for qualitative variables. This study also conducted receiver operating characteristic (ROC) curve analysis to determine the cut-off point and the optimum specificity and sensitivity for each variable. Results: Among 1232 patients, 33.5% had a positive biopsy result. The median age and PSA (68 years and 57.45 ng/ml) in the positive biopsy group was higher than in the negative group (65 years and 11.69 ng/ml), p <0.001. PSAD in patients with PSA 4-10 ng/ml, 10-20 ng/ml, and 20 ng/ml (0.20, 0.35, 2.05) in positive group was higher than negative group (0.14, 0.24, 0.53), p <0.001. Those with a positive biopsy result had a lower median PV (42 ml (range, 13.8-208)) compared to those with negative biopsies (55.4 ml) (p <0.001). In ROC curve, PSAD had the highest sensitivity and specificity (81.4% and 82.0%) with a cut-off point of 0.43 ng/ml/ml (p <0.001). Conclusion: The incidence of PCa increased with higher PSA level, older age and lower PV. Utilization of PSAD 0.17 ng/ml/ml as a cut-off point in patients with PSA level between 4-10 ng/ml is recommended to improve PCa detection in Indonesian men.

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