Transperineal 3D mapping biopsy of the prostate: An essential tool in selecting patients for focal prostate cancer therapy
Transperineal 3D mapping biopsy of the prostate: An essential tool in selecting patients for focal prostate cancer therapy
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DOI：
10.1016/j.urolonc.2008.03.005
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发表时间：
2008-09-01
影响因子：
2.7
通讯作者：
Barzell, Winston
中科院分区：
文献类型：
--
作者：
Onik, Gary;Barzell, Winston
简介：病理学文献表明，25%的前列腺癌患者有一个单一的肿瘤，没有证据表明多灶性疾病。先前发表的结果表明，局部冷冻消融前列腺癌治疗可以提供良好的癌症控制，降低发病率。然而，正确选择只有单灶性疾病的患者对于这种管理策略的成功至关重要。在这项研究中，我们提出了我们的经验，经会阴三维映射活检作为一个额外的分期程序之前，局灶性前列腺癌therapy.Methods：活检方法包括经会阴的方法进行经直肠超声引导下。使用近距离放射治疗网格，在前列腺体积内每5 mm采集一次样本。每个样本被单独标记为它的网格location.Results：110例，所有的人都有单侧疾病经直肠超声（TRUS）活检，使用3D映射方法之前，焦点治疗重新分级。取芯的中位数为46（SI）19）。双侧癌60例（55%）。所有患者在TRUS活检中仅显示单侧癌症。25例患者（23%）的Gleason评分高于TRUS活检。并发症是自限性的，包括9例（8%）谁需要短期留置导管引流和2血尿。结论：经会阴三维映射前列腺活检是耐受性良好，并提供上级分期信息TRUS活检相比。它应该是一个重要的组成部分，在选择患者的局灶性前列腺癌治疗。(C)2008年爱思唯尔公司All rights reserved.
Introduction: The pathologic literature indicates that 25% of prostate cancer patients have a single tumor without evidence for multifocal disease. Previously published results indicate that a focal cryoablative prostate cancer treatment may provide good cancer control with decreased morbidity. Proper selection of patients who have only unifocal disease, however, is critical for such a management strategy to be successful. In this study, we present our experience with transperineal 3D mapping biopsy used as an additional staging procedure prior to focal prostate cancer therapy.Methods: The biopsy method consisted of a transperineal approach carried out under transrectal ultrasound guidance. Samples were taken every 5 mm throughout the volume of the prostate using a brachytherapy grid. Each sample was labeled separately as to its grid location.Results: One hundred ten patients, all of whom had unilateral disease on transrectal ultrasound (TRUS) biopsies, were restaged using the 3D mapping method prior to focal therapy. The median number of cores taken was 46 (SI) 19). Bilateral cancer was demonstrated in 60 patients (55%. all of whom had only unilateral cancer shown on TRUS biopsy. The Gleason score was increased in 25 patients (23%) over the TRUS biopsy. Complications were self-limited and included 9 patients (8%) who required short term indwelling catheter drainage and 2 with hematuria.Conclusions: Transperineal 3D mapping biopsy of the prostate is well tolerated and provides superior staging information compared with TRUS biopsy. It should be an essential component in selecting patients for focal prostate cancer therapy. (C) 2008 Elsevier Inc. All rights reserved.