Revista: | International braz j urol |
Base de datos: | PERIÓDICA |
Número de sistema: | 000434910 |
ISSN: | 1677-5538 |
Autores: | Kayano, Paulo Priante1 Carneiro, Arie1 Castilho, Tiago Mendonca Lopez1 Sivaraman, Arjun2 Claros, Oliver Rojas1 Baroni, Ronaldo Hueb1 Garcia, Rodrigo Gobbo1 Mariotti, Guilherme Cayres1 Smaletz, Oren1 Filippi, Renne Zon1 Lemos, Gustavo Caserta1 |
Instituciones: | 1Hospital Israelita Albert Einstein, Sao Paulo. Brasil 2Memorial Sloan Kettering Cancer Center, Nueva York. Estados Unidos de América |
Año: | 2018 |
Periodo: | Nov-Dic |
Volumen: | 44 |
Número: | 6 |
País: | Brasil |
Idioma: | Inglés |
Tipo de documento: | Artículo |
Enfoque: | Analítico, descriptivo |
Resumen en inglés | Purpose: Ultrasound-magnetic resonance imaging (US-MRI) fusion biopsy (FB) improves the detection of clinically significant prostate cancer (PCa). We aimed to compare the Gleason upgrading (GU) rates and the concordance of the Gleason scores in the biopsy versus final pathology after surgery in patients who underwent transrectal ultrasound (TRUS) systematic random biopsies (SRB) versus US-MRI FB for PCa. Materials and Methods: A retrospective analysis of data that were collected prospectively from January 2011 to June 2016 from patients who underwent prostate biopsy and subsequent radical prostatectomy. The study cohort was divided into two groups: US-MRI FB (Group A) and TRUS SRB (Group B). US-MRI FB was performed in patients with a previous MRI with a focal lesion with a Likert score ≥3; otherwise, a TRUS SRB was performed. Results: In total, 73 men underwent US-MRI FB, and 89 underwent TRUS SRB. The GU rate was higher in Group B (31.5% vs. 16.4%; p=0.027). According to the Gleason grade pattern, GU was higher in Group B than in Group A (40.4% vs. 23.3%; p=0.020). Analyses of the Gleason grading patterns showed that Gleason scores 3+4 presented less GU in Group A (24.1% vs. 52.6%; p=0.043). The Bland-Altman plot analysis showed a higher bias in Group B than in Group A (-0.27 [-1.40 to 0.86] vs. −0.01 [-1.42 to 1.39]). In the multivariable logistic regression analysis, the only independent predictor of GU was the use of TRUS SRB (2.64 [1.11 – 6.28]; p=0.024). Conclusions: US-MRI FB appears to be related to a decrease in GU rate and an increase in concordance between biopsy and final pathology compared to TRUS SRB, suggesting that performing US-MRI FB leads to greater accuracy of diagnosis and better treatment decisions |
Disciplinas: | Medicina |
Palabras clave: | Oncología, Urología, Diagnóstico, Neoplasias, Próstata, Biopsia transrectal, Espectroscopia de resonancia magnética, Puntaje de Gleason, Estudios comparativos |
Keyword: | Oncology, Urology, Diagnosis, Neoplasms, Prostate, Transrectal biopsy, Magnetic resonance spectroscopy, Gleason score, Comparative studies |
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