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Çelik S, Kızılay F, Yörükoğlu K, Aslan G, Ozen H, Akdogan B, Sozen S, Baltaci S, Muezzinoglu T, Izol V, Bayazıt Y, Narter F, Türkeri L. Sextant Biopsy-Based Criteria for Clinically Insignificant Prostate Cancer Are Also Valid for the 12-Core Prostate Biopsy Scheme: A Multicenter Study of Urooncology Association, Turkey. Urol Int 2021; 106:35-43. [PMID: 33951662 DOI: 10.1159/000513658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 12/07/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Epstein criteria based on sextant biopsy are assumed to be valid for 12-core biopsies. However, very scarce information is present in the current literature to support this view. OBJECTIVES To investigate the validity of Epstein criteria for clinically insignificant prostate cancer (PCa) in a cohort of the currently utilized 12-core prostate biopsy (TRUS-Bx) scheme in patients with low-risk and intermediate-risk PCa. METHOD Pathological findings were separately evaluated in the areas matching the sextant biopsy (6-core paramedian) scheme and in all 12-core schemes. Patients were divided into 2 groups according to the final pathology report of RP as true clinically significant PCa (sPCa) and insignificant PCa (insPCa) groups. Predictive factors (including Epstein criteria) and cutoff values for the presence of insPCa were separately evaluated for 6- and 12-core TRUS-Bx schemes. Then, different predictive models based on Epstein criteria with or without additional biopsy findings were created. RESULTS A total of 442 patients were evaluated. PSA density, biopsy GS, percentage of tumor and number of positive cores, PNI, and HG-PIN were independent predictive factors for insPCa in both TRUS-Bx schemes. For the 12-core scheme, the best cutoff values of tumor percentage and number of positive cores were found to be ≤50% (OR: 3.662) and 1.5 cores (OR: 2.194), respectively. The best predictive model was found to be that which added 3 additional factors (PNI and HG-PIN absence and number of positive cores) to Epstein criteria (OR: 6.041). CONCLUSIONS Using a cutoff value of "1" for the number of positive biopsy cores and absence of biopsy PNI and HG-PIN findings can be more useful for improving the prediction model of the Epstein criteria in the 12-core biopsy scheme.
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Affiliation(s)
- Serdar Çelik
- Department of Basic Oncology, Izmir Bozyaka Training and Research Hospital, Institute of Oncology, Health Science University, Urology Clinic and Dokuz Eylul University, Izmir, Turkey
| | - Fuat Kızılay
- Department of Urology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Kutsal Yörükoğlu
- Department of Pathology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Güven Aslan
- Department of Urology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Haluk Ozen
- Department of Urology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Bulent Akdogan
- Department of Urology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sinan Sozen
- Department of Urology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Sumer Baltaci
- Department of Urology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Talha Muezzinoglu
- Department of Urology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Volkan Izol
- Department of Urology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Yıldırım Bayazıt
- Department of Urology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Fehmi Narter
- Department of Urology, Kadikoy Hospital, Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Levent Türkeri
- Department of Urology, Altunizade Hospital, Mehmet Ali Aydınlar Acıbadem University, Istanbul, Turkey
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Celik S, Bozkurt O, Demir O, Gurboga O, Tuna B, Yorukoglu K, Aslan G. Effects of perineural invasion in prostate needle biopsy on tumor grade and biochemical recurrence rates after radical prostatectomy. Kaohsiung J Med Sci 2018; 34:385-390. [PMID: 30063011 DOI: 10.1016/j.kjms.2017.12.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 11/14/2017] [Accepted: 12/28/2017] [Indexed: 10/18/2022] Open
Abstract
To predict local invasive disease before retropubic radical prostatectomy (RRP), the correlation of perineural invasion (PNI) on prostate needle biopsy (PNB) and RRP pathology data and the effect of PNI on biochemical recurrence (BR) were researched. For patients with RRP performed between 2005 and 2014, predictive and pathologic prognostic factors were assessed. Initially all and D'Amico intermediate-risk group patients were comparatively assessed in terms of being T2 or T3 stage on RRP pathology, positive or negative for PNI presence on PNB and positive or negative BR situation. Additionally the effect of PNI presence on recurrence-free survival (RFS) rate was investigated. When all patients are investigated, multivariate analysis observed that in T3 patients PSA, PNB Gleason score (GS) and tumor percentage were significantly higher; in PNI positive patients PNB GS, core number and tumor percentage were significantly higher and in BR positive patients PNB PNI positivity and core number were significantly higher compared to T2, PNI negative and BR negative patients, separately (p < 0.05). When D'Amico intermediate-risk patients are evaluated, for T3 patients PSA and PNB tumor percentage; for PNI positive patients PNB core number and tumor percentage; and for BR positive patients PNB PNI positivity were significantly higher compared to T2, PNI negative and BR negative patients, separately (p < 0.05). Mean RFS in the whole patient group was 56.4 ± 4.2 months for PNI positive and 96.1 ± 5.7 months for negative groups. In the intermediate-risk group, mean RFS was 53.7 ± 5.1 months for PNI positive and 100.3 ± 7.7 months for negative groups (p < 0.001). PNI positivity on PNB was shown to be an important predictive factor for increased T3 disease and BR rates and reduced RFS.
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Affiliation(s)
- Serdar Celik
- Department of Urology, School of Medicine, Dokuz Eylul University, Izmir, Turkey.
| | - Ozan Bozkurt
- Department of Urology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Omer Demir
- Department of Urology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ozgur Gurboga
- Department of Urology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Burcin Tuna
- Department of Pathology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Kutsal Yorukoglu
- Department of Pathology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Guven Aslan
- Department of Urology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
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