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Is it necessary for all patients with suspicious lesions undergo systematic biopsy in the era of MRI-TRUS fusion targeted biopsy?
Lv, Zhengtong; Wang, Jinfu; Wang, Miao; Hou, Huimin; Song, Liuqi; Li, Haodong; Wang, Xuan; Liu, Ming.
Afiliação
  • Lv, Zhengtong; National Center of Gerontology. Institute of Geriatric Medicine. Chinese Academy of Medical Sciences. P.R. CN
  • Wang, Jinfu; National Center of Gerontology. Institute of Geriatric Medicine. Chinese Academy of Medical Sciences. P.R. CN
  • Wang, Miao; National Center of Gerontology. Institute of Geriatric Medicine. Chinese Academy of Medical Sciences. P.R. CN
  • Hou, Huimin; National Center of Gerontology. Institute of Geriatric Medicine. Chinese Academy of Medical Sciences. P.R. CN
  • Song, Liuqi; National Center of Gerontology. Institute of Geriatric Medicine. Chinese Academy of Medical Sciences. P.R. CN
  • Li, Haodong; National Center of Gerontology. Institute of Geriatric Medicine. Chinese Academy of Medical Sciences. P.R. CN
  • Wang, Xuan; National Center of Gerontology. Institute of Geriatric Medicine. Chinese Academy of Medical Sciences. P.R. CN
  • Liu, Ming; National Center of Gerontology. Institute of Geriatric Medicine. Chinese Academy of Medical Sciences. P.R. CN
Int. braz. j. urol ; 49(3): 359-371, may-June 2023. tab, graf
Article em En | LILACS-Express | LILACS | ID: biblio-1440259
Biblioteca responsável: BR1.1
ABSTRACT
ABSTRACT Purpose Targeted biopsy (TB) combined with systematic biopsy (SB) is an optimized mode of prostate biopsy but can often lead to oversampling and overdiagnosis accompanied by potential biopsy-related complications and patient discomfort. Here, we attempted to reasonably stratify the patient population based on multi-parameter indicators with the aim of avoiding unnecessary SB. Methods In total, 340 biopsy-naïve men with suspected lesions, prostate-specific antigen (PSA) < 20 ng/mL and prostate imaging-reporting and data system (PI-RADS) ≥ 3 enrolled for study underwent both TB and SB. The primary outcome was to determine independent predictors for a valid diagnosis, assuming that only TB was performed and SB omitted (defined as mono-TB), taking TB + SB as the reference standard. The secondary outcomes were exploration of the predictive factors of mono-TB and TB + SB in detection of prostate cancer (PCa) and clinically significant PCa (csPCa). Results The mean PSA density (PSAD) of patient group was 0.27 ng/mL/mL. Multiparametric MRI PI-RADS scores were 3-5 in 146 (42.94%), 105 (30.88%), and 89 (26.18%) cases, respectively. PCa and csPCa were detected in 178/340 (52.35%) and 162/340 (47.65%) patients, respectively. Overall, 116/178 (65.17%) patients diagnosed with PCa displayed pathological consistencies between mono-TB and TB + SB modes. PSAD and PI-RADS were independent predictors of valid diagnosis using mono-TB. Conclusions PSAD combined with PI-RADS showed utility in guiding optimization of the prostate biopsy mode. Higher PSAD and PI-RADS values were associated with greater confidence in implementing mono-TB and safely omitting SB, thus effectively balancing the benefits and risks.
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Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Tipo de estudo: Prognostic_studies Idioma: En Revista: Int. braz. j. urol Assunto da revista: UROLOGIA Ano de publicação: 2023 Tipo de documento: Article / Project document País de afiliação: China País de publicação: Brasil
Texto completo
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Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Tipo de estudo: Prognostic_studies Idioma: En Revista: Int. braz. j. urol Assunto da revista: UROLOGIA Ano de publicação: 2023 Tipo de documento: Article / Project document País de afiliação: China País de publicação: Brasil