Confirmatory biopsy for the assessment of prostate cancer in men considering active surveillance: Reference centre experience

Cecilia Bosco, Gabriele Cozzi, Janette Kinsella, Roberto Bianchi, Peter Acher, Benjamin Challacombe, Rick Popert, Christian Brown, Gincy George, Mieke Van Hemelrijck, Declan Cahill

Research output: Contribution to journalArticle

Abstract

Objectives: To evaluate how accurate a 12-core transrectal biopsy derived low-risk prostate cancer diagnosis is for an active surveillance programme by comparing the histological outcome with that from confirmatory transperineal sector biopsy. Subjects and methods: The cohort included 166 men diagnosed with low volume Gleason score 3+3 prostate cancer on initial transrectal biopsy who also underwent a confirmatory biopsy. Both biopsy techniques were performed according to standard protocols and samples were taken for histopathology analysis. Subgroup analysis was performed according to disease severity at baseline to determine possible disease parameters of upgrading at confirmatory biopsy. Results: After confirmatory biopsy, 34% demonstrated Gleason score upgrade, out of which 25% were Gleason score 3+4 and 8.5% primary Gleason pattern 4. Results remained consistent for the subgroup analysis and a weak positive association, but not statistically significant, between prostate specific antigen (PSA), age, and percentage of positive cores, and PCa upgrading at confirmatory biopsy was found. Conclusion: In our single centre study, we found that one-third of patients had higher Gleason score at confirmatory biopsy. Furthermore 8.5% of these upgraders had a primary Gleason pattern 4. Our results together with previously published evidence highlight the need for the revision of current guidelines in prostate cancer diagnosis for the selection of men for active surveillance.

Original languageEnglish
Article number633
Journalecancermedicalscience
Volume10
DOIs
Publication statusPublished - Apr 14 2016

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Keywords

  • Active surveillance
  • Confirmatory biopsy
  • Prostate biopsy
  • Prostate cancer
  • Transperineal sector biopsy
  • Transrectal biopsy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Bosco, C., Cozzi, G., Kinsella, J., Bianchi, R., Acher, P., Challacombe, B., Popert, R., Brown, C., George, G., Van Hemelrijck, M., & Cahill, D. (2016). Confirmatory biopsy for the assessment of prostate cancer in men considering active surveillance: Reference centre experience. ecancermedicalscience, 10, [633]. https://doi.org/10.3332/ecancer.2016.633