Comparison of the Upgrading Rates of International Society of Urological Pathology Grades and Tumor Laterality in Patients Undergoing Standard 12-Core Prostate Biopsy versus Fusion Prostate Biopsy for Prostate Cancer

Urol Int. 2019;103(3):256-261. doi: 10.1159/000501528. Epub 2019 Jun 26.

Abstract

Background: Histopathological discrepancies between biopsy and radical prostatectomy (RP) specimens may lead to unnecessary, excessive, or incomplete treatment in prostate cancer (PCa) patients.

Objectives: To compare the upgrading rates of International Society of Urological Pathology (ISUP) grades and tumor laterality in patients that underwent standard 12-core transrectal ultrasound-guided standard prostate biopsy (SPB) versus multiparametric magnetic resonance-guided fusion prostate biopsy (FPB) for PCa.

Methods: This retrospective study included 152 patients that underwent prostate biopsy and RP in our clinic. The patients were divided into 2 groups: Group A (n = 90) included patients that underwent SPB and Group B (n = 62) included patients that underwent FPB (targeted biopsy + standard biopsy). Upgrading of ISUP grades, tumor laterality, and upgrading of tumor laterality were compared between the 2 groups. Upgrading of tumor laterality defined as detection of tumor at both lobes in RP pathology while it was at unilateral lobe in biopsy pathology.

Results: ISUP grade 1 was the most common histopathology in both groups. The ISUP upgrading rate on final pathology was significantly lower in the FPB group compared to the SPB group (22.7 vs. 37.7%; p < 0.048). Similarly, the upgrading rate of tumor laterality was lower in the FPB group compared to the SPB group (37.7 vs. 9.7%; p < 0.001).

Conclusion: The results suggested that FPB can provide more accurate results compared to SPB.

Keywords: Biopsy; Fusion; Histopathology; Prostate; Upgrade.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Biopsy, Large-Core Needle*
  • Humans
  • Image-Guided Biopsy*
  • International Cooperation
  • Magnetic Resonance Imaging, Interventional*
  • Male
  • Middle Aged
  • Multiparametric Magnetic Resonance Imaging*
  • Neoplasm Grading
  • Pathology, Clinical
  • Prostate / pathology*
  • Prostatectomy
  • Prostatic Neoplasms / pathology*
  • Retrospective Studies
  • Societies, Medical
  • Ultrasonography, Interventional*
  • Urology