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Cancer core length from targeted biopsy: an index of prostate cancer volume and pathological stage
Author(s) -
Simopoulos Demetrios N.,
Sisk Anthony E.,
Priester Alan,
Felker Ely R.,
Kwan Lorna,
Delfin Merdie K.,
Reiter Robert E.,
Marks Leonard S.
Publication year - 2019
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.14691
Subject(s) - medicine , biopsy , prostate cancer , magnetic resonance imaging , lesion , prostatectomy , pathological , stage (stratigraphy) , radiology , cancer , prostate , pathology , nuclear medicine , paleontology , biology
Objective To study the relationship of maximum cancer core length (MCCL), on targeted biopsy (TB) of magnetic resonance imaging ( MRI )‐visible index lesions, to volume of that tumour found at radical prostatectomy (RP). Patients and Methods In all, 205 men undergoing fusion biopsy and RP were divided into two groups: 136 in whom the MCCL came from an index MRI ‐visible lesion (TB) and 69 in whom MCCL came from a non‐targeted lesion (non‐targeted biopsy [NTB]). MRI was 3‐T multi‐parametric and biopsy was via MRI ‐ ultrasonography fusion. Results In the TB group, MCCL correlated with volume of clinically significant index tumours (ρ = 0.44–0.60, P < 0.01). The correlation was similar for first and repeat biopsy and for transition and peripheral zone lesions (ρ = 0.42–0.49, P < 0.01). No correlations were found in the NTB group. TB MCCL (6–10 and >10 mm) and MRI lesion diameter (>20 mm) were independently associated with tumour volume. TB MCCLs >10 mm and Gleason scores >7 were each associated with pathological T3 disease (odds ratios 5.73 and 5.04, respectively), but MRI lesion diameter lesion was not. Conclusions MCCL on a TB from an MRI ‐visible lesion is an independent predictor of both cancer volume and pathological stage. This relationship does not exist for MCCL from a NTB core. Quantifying CCL on MRI ‐TBs may have a value, not previously described, to risk‐stratify patients with prostate cancer before treatment.