Prostate Cancers Detected by Magnetic Resonance Imaging--Targeted Biopsies Have a Higher Percentage of Gleason Pattern 4 Component and Are Less Likely to Be Upgraded in Radical Prostatectomies.

* Context.--In Gleason score (GS) 7 prostate cancers, the quantity of Gleason pattern 4 (GP 4) is an important prognostic factor and influences treatment decisions. Magnetic resonance imaging (MRI)--targeted biopsy has been increasingly used in clinical practice. Objective.--To investigate whether M...

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Publicado en:Archives of Pathology & Laboratory Medicine Vol. 143; no. 1; pp. 86 - 92
Autores principales: Yani Zhao, Fang-Ming Deng, Hongying Huang, Peng Lee, Lepor, Hebert, Rosenkrantz, Andrew B., Taneja, Samir, Melamed, Jonathan, Ming Zhou
Formato: research tables/charts Journal Article
Publicado: College of American Pathologists Jan2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2019
      vid: 143
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      pub: College of American Pathologists
      place: Northfield, Illinois
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        133748690
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        10.5858/arpa.2017-0410-OA
        133748690
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        atl: Prostate Cancers Detected by Magnetic Resonance Imaging--Targeted Biopsies Have a Higher Percentage of Gleason Pattern 4 Component and Are Less Likely to Be Upgraded in Radical Prostatectomies.
      aug:
        au:
          Yani Zhao
          Fang-Ming Deng
          Hongying Huang
          Peng Lee
          Lepor, Hebert
          Rosenkrantz, Andrew B.
          Taneja, Samir
          Melamed, Jonathan
          Ming Zhou
        affil: Department of Pathology, New York University Langone Medical Center, New York, New York
      sug:
        subj:
          Prostatic Neoplasms Diagnosis
          Magnetic Resonance Imaging Methods
          Biopsy Methods
          Prostatic Neoplasms Surgery
          Prostatectomy, Radical
          Neoplasm Grading
          Human
      ab: * Context.--In Gleason score (GS) 7 prostate cancers, the quantity of Gleason pattern 4 (GP 4) is an important prognostic factor and influences treatment decisions. Magnetic resonance imaging (MRI)--targeted biopsy has been increasingly used in clinical practice. Objective.--To investigate whether MRI-targeted biopsy may detect GS 7 prostate cancer with greater GP 4 quantity, and whether it improves biopsy/radical prostatectomy GS concordance. Design.--A total of 243 patients with paired standard and MRI-targeted biopsies with cancer in either standard or targeted or both were studied, 65 of whom had subsequent radical prostatectomy. The biopsy findings, including GS and tumor volume, were correlated with the radical prostatectomy findings. Results.--More prostate cancers detected by MRItargeted biopsy were GS 7 or higher. Mean GP 4 percentage in GS 7 cancers was 31.0% ± 29.3% by MRI-targeted biopsy versus 25.1% ± 29.5% by standard biopsy. A total of 122 of 218 (56.0%) and 96 of 217 (44.2%) prostate cancers diagnosed on targeted biopsy and standard biopsy, respectively, had a GP 4 of 10% or greater (P = .01). Gleason upgrading was seen in 12 of 59 cases (20.3%) from MRI-targeted biopsy and in 24 of 57 cases (42.1%) from standard biopsy (P = .01). Gleason upgrading correlated with the biopsy cancer volume inversely and GP 4 of 30% or less in standard biopsy. Such correlation was not found in MRI-targeted biopsy. Conclusions.--Magnetic resonance imaging--targeted biopsy may detect more aggressive prostate cancers and reduce the risk of Gleason upgrading in radical prostatectomy. This study supports a potential role for MRI-targeted biopsy in the workup of prostate cancer and inclusion of percentage of GP 4 in prostate biopsy reports.
      pubtype: Academic Journal
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        research
        tables/charts
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      ougenre: Article
    language: English
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