000130469 001__ 130469
000130469 005__ 20240125162930.0
000130469 0247_ $$2doi$$a10.1016/j.urolonc.2020.10.016
000130469 0248_ $$2sideral$$a121265
000130469 037__ $$aART-2021-121265
000130469 041__ $$aeng
000130469 100__ $$aMorote, Juan
000130469 245__ $$aPrediction of clinically significant prostate cancer after negative prostate biopsy: The current value of microscopic findings
000130469 260__ $$c2021
000130469 5203_ $$aObjective
To assess the current ability of atypical small acinar proliferation (ASAP), multifocal high-grade prostatic intraepithelial neoplasia (mHGPIN), HGPIN with atypia (PINATYP) and other non-malignant lesions to predict clinically significant prostate cancer (csPCa) in repeat prostate biopsies.
Methods
This retrospective study analyzed 377 repeat prostate biopsies, carried out between 2.014 and 2.017, and excluding those with previous PCa or 5-alpha reductase inhibitors treatment. ASAP, mHGPIN, PINATYP, prostatic atrophy, prostatic hyperplastic atrophy, proliferative inflammatory atrophy (PIA), chronic prostatitis, acute prostatitis, or granulomatous prostatitis, were prospectively reported after 12-core transrectal ultrasound (TRUS) systematic negative previous biopsies. 3T-multiparametric magnetic resonance imaging (mpMRI) was performed previous repeat biopsies. At least 2-core TRUS targeted biopsies of Prostate Imaging-Reporting and Data Systemv2 lesions ≥3, and/or 12-core TRUS systematic biopsy were performed in repeat prostate biopsies. The main outcome measurements were csPCa detection, which was defined when the International Society of Uro-Pathology group grade >1 and avoided biopsies. After logistic regression analysis the most efficient model was selected, nomogram was designed with internal validation, and clinical utility was analyzed.
Results
Normal benign tissue alone was present in less than 2% of previous negative biopsies. mHGPIN (39.7%), ASAP (4.3%) and PINATYP (3.7%) failed to predict csPCa risk in repeat biopsies. The finding of PIA (38.2%) associated with a decreased the risk of csPCa with an Odd ratio of 0.54 (95% confidence interval: 0.31–0.95), P= 0.031. The area under the curve, to predict csPCa, of mpMRI was 0.736, increasing up to 0.860 (95% confidence internal:0.82–0.90) when PSA density, age, digital rectal examination, and differential PSA between biopsies and PIA finding were integrated in a predictive model. At 6% threshold, more than 20% of repeat prostate biopsies were saved without missing csPCa.
Conclusion
Currently, mHGPIN in negative prostate biopsy seems not able to predict the risk of future csPCa. The low incidence of ASAP and PINATYP, in our series, did not allow us to draw conclusions. PIA finding associated with a reduced risk of csPCa, and it could be integrated in a useful based-mpMRI predictive nomogram.
000130469 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/
000130469 590__ $$a2.954$$b2021
000130469 591__ $$aUROLOGY & NEPHROLOGY$$b47 / 90 = 0.522$$c2021$$dQ3$$eT2
000130469 591__ $$aONCOLOGY$$b182 / 245 = 0.743$$c2021$$dQ3$$eT3
000130469 592__ $$a0.818$$b2021
000130469 593__ $$aUrology$$c2021$$dQ1
000130469 593__ $$aOncology$$c2021$$dQ1
000130469 594__ $$a4.7$$b2021
000130469 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000130469 700__ $$aSchwartzman, Iván
000130469 700__ $$0(orcid)0000-0003-0178-4567$$aBorque, Ángel$$uUniversidad de Zaragoza
000130469 700__ $$0(orcid)0000-0002-3007-302X$$aEsteban Escaño, Luis Mariano
000130469 700__ $$aCelma, Anna
000130469 700__ $$aRoche, Sarai
000130469 700__ $$ade Torres, Inés
000130469 700__ $$aMast, Richard
000130469 700__ $$aSemidey, María Eugenia
000130469 700__ $$aRegis, Lucas
000130469 700__ $$aSantamaria, Anna
000130469 700__ $$aPlanas, Jacques, Trilla, Enrique
000130469 7102_ $$11013$$2817$$aUniversidad de Zaragoza$$bDpto. Cirugía$$cÁrea Urología
000130469 773__ $$g39, 7 (2021), 432.e11-432.e19$$pUrol. Oncol.-Semin. Orig. Investig$$tUROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS$$x1078-1439
000130469 8564_ $$s1176749$$uhttps://zaguan.unizar.es/record/130469/files/texto_completo.pdf$$yVersión publicada
000130469 8564_ $$s2447947$$uhttps://zaguan.unizar.es/record/130469/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000130469 909CO $$ooai:zaguan.unizar.es:130469$$particulos$$pdriver
000130469 951__ $$a2024-01-25-15:13:14
000130469 980__ $$aARTICLE