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Incidence, grade and distribution of prostate cancer following transperineal template-guided mapping biopsy in patients with atypical small acinar proliferation

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Abstract

Purpose

To evaluate the role of transperineal template-guided mapping biopsy (TTMB) in patients with atypical small acinar proliferation (ASAP) diagnosed via transrectal ultrasound-guided needle biopsy (TRUS).

Methods

In total, 132 consecutive patients with TRUS-diagnosed ASAP underwent TTMB by means of an anatomic-based technique with sampling of 24 biopsy regions. For each of the 24 regions, 1–3 biopsy cores were obtained (depending on prostate size). No patient underwent pre-biopsy MRI imaging. The Gleason score, location of each positive biopsy core, the number of biopsy cores and percent involvement of each core were recorded. Anterior versus posterior cancer distribution was determined for both low- and high-grade (Gleason score ≥7) cancer.

Results

The mean patient age was 63.8 years with a mean PSA of 6.8 ng/mL. Of the 132 patients, 86 (65.2%) were diagnosed with prostate cancer. Of the entire cohort, 47 patients (54.7% of cancer patients and 35.6% of the entire cohort) were diagnosed with Gleason score ≥7. For both low- and high-grade cancers, the anterior gland and especially the anterior apex were the most common cancer locations.

Conclusion

In patients with ASAP, TTMB diagnosed prostate cancer in 65.2% of patients and 35.6% of the entire cohort had high-grade prostate cancer. A predilection for anterior-based cancers, especially the anterior apex, was identified. Our study may serve as a baseline reference for MRI-guided biopsy regimens.

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Authors’ contributions

G.S.M., MD, contributed to protocol/project development, data collection, data analysis and manuscript writing, R.W.G., PhD, contributed to data management and data analysis, A.B., BS, contributed to data management and data analysis, W.M. B., PhD, contributed to data management, data analysis and manuscript editing and E.A., MD, contributed to data collection and manuscript editing.

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Authors and Affiliations

  1. Schiffler Cancer Center, Wheeling Hospital, Wheeling Jesuit University, Wheeling, WV, 26003, USA

    Gregory S. Merrick, Robert W. Galbreath, Abbey Bennett & Wayne M. Butler

  2. Department of Urology, Wheeling Hospital, Wheeling, WV, USA

    Gregory S. Merrick

  3. Ohio University Eastern, St. Clairsville, OH, USA

    Robert W. Galbreath

  4. Department of Pathology, Wheeling Hospital, Wheeling, WV, USA

    Edward Amamovich

Authors
  1. Gregory S. Merrick
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  2. Robert W. Galbreath
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  3. Abbey Bennett
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  4. Wayne M. Butler
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  5. Edward Amamovich
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Corresponding author

Correspondence to Gregory S. Merrick.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Human and animal rights

This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Merrick, G.S., Galbreath, R.W., Bennett, A. et al. Incidence, grade and distribution of prostate cancer following transperineal template-guided mapping biopsy in patients with atypical small acinar proliferation. World J Urol 35, 1009–1013 (2017). https://doi.org/10.1007/s00345-016-1976-2

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  • DOI: https://doi.org/10.1007/s00345-016-1976-2

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