Are transition zone biopsies still necessary to improve prostate cancer detection?: Results from the Tyrol screening project

被引:72
作者
Pelzer, AE
Bektic, J
Berger, AP
Halpern, EJ
Koppelstätter, F
Klauser, A
Rehder, P
Horninger, W
Bartsch, G
Frauscher, F
机构
[1] Univ Innsbruck, Dept Urol, A-6020 Innsbruck, Austria
[2] Innsbruck Med Univ, Dept Radiol, Innsbruck, Austria
[3] Thomas Jefferson Univ, Dept Radiol, Jefferson Prostate Diagnost Ctr, Philadelphia, PA USA
关键词
ultrasound; transition zone cancer; color Doppler; prostate biopsy;
D O I
10.1016/j.eururo.2005.07.012
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objectives: The present retrospective study was designed to investigate the value of transition zone (TZ) biopsies for prostate cancer (PC) detection rate in a combined contrast enhanced color Doppler targeted (CECD) and gray-scale systematic biopsy (SB) approach. Methods: PSA screening participants totalling 1475 with tPSA of > 1.25 ng/ml (fPSA <= 18%) were assessed. Ten SB and additionally 5 or fewer CECD were performed. The impact of TZ biopsies on the PC detection rate and the biological significance of the detected TZ-cancers were analyzed. Results: Out of 1475 biopsied patients, 395 (26.8%) were identified as PC patients; 5925 biopsy cores from these patients were analyzed. In 86 patients (21.8% of PC), we found 102 PC-positive cores in the TZ, and only in 9 of them solitary TZ-cancers without any other PC-location (2.3% of PC or 0.6% of all investigated patients). Pathologic findings after retropubic prostatectomy (RPE) revealed multifocal adenocarcinoma including involved peripheral zone (PZ) in eight of these nine patients, and solitary TZ-cancer in one patient. There was no positive correlation between prostate volume and TZ-detection rate and no patient with solitary TZ-PC after rebiopsy. Conclusion: Biopsy revealed 9 solitary TZ cancers (1.8%) and RPE revealed only one of them to be truly TZ-confined cancer (0.6%). Furthermore PC-detection did not improve, even in patients with rebiopsy, and there was no correlation between detection of TZ-cancers and prostate volume. A combined use of CECD and SB to investigate participants of a PSA-screening program suggests that TZ-biopsies do not improve PC detection rate and are therefore unnecessary. (c) 2005 Elsevier B.V. All rights reserved.
引用
收藏
页码:916 / 921
页数:6
相关论文
共 27 条
[1]  
[Anonymous], J UROLOGY
[2]   Extended field prostate biopsy enhances cancer detection [J].
Babaian, RJ .
UROLOGY, 2000, 55 (04) :453-456
[3]   Polymer/additive analysis by flash pyrolysis techniques [J].
Bart, JCJ .
JOURNAL OF ANALYTICAL AND APPLIED PYROLYSIS, 2001, 58 :3-28
[4]   Prospective evaluation of systematic sextant transition zone biopsies in large prostates for cancer detection [J].
Chang, JJ ;
Shinohara, K ;
Hovey, RM ;
Montgomery, C ;
Presti, JC .
UROLOGY, 1998, 52 (01) :89-93
[5]   Prospective evaluation of lateral biopsies of the peripheral zone for prostate cancer detection [J].
Chang, JJ ;
Shinohara, K ;
Bhargava, V ;
Presti, JC .
JOURNAL OF UROLOGY, 1998, 160 (06) :2111-2114
[6]   Optimization of prostate biopsy strategy using computer based analysis [J].
Chen, ME ;
Troncoso, P ;
Johnston, DA ;
Tang, K ;
Babaian, RJ .
JOURNAL OF UROLOGY, 1997, 158 (06) :2168-2175
[7]   Is one set of sextant biopsies enough to rule out prostate cancer?: Influence of transition and total prostate volumes on prostate cancer yield [J].
Djavan, B ;
Zlotta, AR ;
Ekane, S ;
Remzi, M ;
Kramer, G ;
Roumeguère, T ;
Etemad, M ;
Wolfram, R ;
Schulman, CC ;
Marberger, M .
EUROPEAN UROLOGY, 2000, 38 (02) :218-224
[8]   Systematic 5 region prostate biopsy is superior to sextant method for diagnosing carcinoma of the prostate [J].
Eskew, LA ;
Bare, RL ;
McCullough, DL .
JOURNAL OF UROLOGY, 1997, 157 (01) :199-202
[9]  
ESKEW LA, 1997, J UROLOGY, V157, P202
[10]   Evaluation of transition zone and lateral sextant biopsies for prostate cancer detection after initial sextant biopsy [J].
Fink, KG ;
Hutarew, G ;
Esterbauer, B ;
Pytel, A ;
Jungwirth, A ;
Dietze, O ;
Schmeller, NT .
UROLOGY, 2003, 61 (04) :748-753