Transperineal Prostate Biopsy Better for PCa Risk Statification

It more accurately predicted the actual clinical risk category at final pathology compared with transrectal ultrasonography-guided biopsy.
It more accurately predicted the actual clinical risk category at final pathology compared with transrectal ultrasonography-guided biopsy.

Transperineal template biopsy (TTB) of the prostate more accurately predicts prostate cancer clinical risk category than transrectal ultrasonography-guided prostate biopsy (TRUSB), study findings suggest.

In an Australian study of 431 radical prostatectomy (RP) specimens, Susan Scott, MD, of Griffith University and The Princess Alexandra Hospital in Brisbane, and colleagues found that the proportion of prostate tumors reclassified at final pathology into a higher clinical risk category (from low risk to intermediate or high risk) was significantly greater with TRUSB than TTB (22.3% vs. 14.2%).

The investigators defined low risk as Gleason 6 or less, intermediate risk as Gleason 7, and high risk as Gleason 8–10.

“Our present results indicate that irrespective of the severity of cancer, clinicians may be able to formulate management plans in a multidisciplinary uro-oncology forum more confidently on the basis of TTB results,” Dr. Scott's group reported online ahead of print in BJU International. “The ability to risk stratify patients after biopsy and accurately predict the pathological stage of prostate cancer before definitive treatment is likely to allow for improved patient counseling and understanding, as well as more appropriate ongoing treatment selection.”

The 431 RP specimens included 283 and 148 specimens in which PCa was diagnosed on the basis of TRUSB and TTB, respectively.

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