Characteristics of Prostate Cancers Missed by Biopsies: Evaluation of Cumulative Tumor Volume Missed According to Cancer True Prevalence ()
Affiliation(s)
Astellas Pharma Global Development, Inc., Deerfield, USA.
Department of Pathology, Upstate Medical University, Syracuse, USA.
Department of Urology, Cochin Hospital, Paris Descartes University, Paris, France.
Department of Urology, Lyon South Hospital, Lyon, France.
ABSTRACT
Purpose: To characterize
missed prostate tumors and their cumulative volume with various biopsy regimens
to determine optimal biopsy schemes. Methods: We performed 6, 12 and
18-core needle biopsies on 165 and 36-core biopsies on 47 autopsy prostates, respectively.
The 6-core biopsy included 6 cores from the mid peripheral zone (MPZ), the
12-core biopsy included 6 cores from the MPZ and lateral PZ (LPZ), and the
18-core biopsies included 6 cores from the MPZ, LPZ and central zone (CZ). The
36-core biopsies included 12 cores in each of these 3 areas. We analyzed the
sensitivity of biopsies at each site and evaluated the cumulative volume of
cancers and tumor foci missed. Results: Whole-mount analysis identified
59 cancers, 110 tumor foci, and a total cumulative tumor volume of 43 cm3. The percentage of tumor
foci and corresponding cumulative volume missed with 6, 12, 18 and 36-core
biopsies were of 79% and 58%, 64% and 48%, 57% and 26%, and 42% and 17%,
respectively (p < 0.05). 12-core
biopsies from the MPZ and LPZ performed best for clinically significant cancers
detection. However, increasing the number of cores over
the 6-core biopsy cutoff increased solely the detection of tumor foci < 0.5 cm3. Conclusion: Twelve biopsies
from the MPZ and LPZ detected most of the clinically significant cancers while
missing most of the tumor foci. These missed tumors represented only a small
amount of the overall cancer volume.
Share and Cite:
N. Delongchamps, G. Roza, P. Perrin, M. Peyromaure and G. Haas, "Characteristics of Prostate Cancers Missed by Biopsies: Evaluation of Cumulative Tumor Volume Missed According to Cancer True Prevalence,"
Open Journal of Urology, Vol. 3 No. 5, 2013, pp. 210-216. doi:
10.4236/oju.2013.35039.
Cited by
No relevant information.