The predictive role of MRI cognitive biopsy for gleason score on radical prostatectomy material

Abstract

The diagnostic efficiency of systematic biopsy, which is currently accepted as the standard in primary care, is limited in the diagnosis of prostate cancer (PCa). If the compatibility between prostate biopsy specimens and radical prostatectomy (RP) specimens is better, it is likely that the oncological and functional outcomes of the patients will also improve. In this study, patients who underwent systematic + cognitive or only systematic biopsy after multi-parametric magnetic resonance imaging (mpMRI) with the suspicion of PCa in our clinic and patients who underwent RP with the diagnosis of local / locally advanced PCa as a result of biopsy were examined retrospectively. It was aimed to compare the Gleason score concordance between the biopsy specimens and the RP specimens of the patients.73 patients who underwent RP between November 2015 and November 2017 were included in the study. Four patients who received chemotherapy before RP were excluded from the study. While MRI cognitive + systematic biopsy was performed in 38 patients, only systematic biopsy was performed in 31 patients. In the last stage, histopathological results of MRI cognitive + systematic biopsy, only systematic biopsy and RP specimens were compared retrospectively. When compared according to RP results, Gleason score was decreased in 5 (13.2%) of 38 patients who underwent MRI cognitive + systematic biopsy, did not change in 22 patients (57.9%) and was increased in 11 (28.9%) patients. Of the 31 patients who underwent only systematic biopsy, Gleason score decreased in 2 patients (6.5%), remained unchanged in 10 patients (32.3%), and increased in 19 patients (61.3%). Statistically significant difference was found between those who underwent MRI cognitive + systematic biopsy and those who only underwent systematic biopsy in terms Gleason score concordance according to the RP result (p=0.026). Gleason grade of tumors after RP can be more accurately predicted with MRI cognitive + systematic biopsy. Thus, surgical success may increase (necessity of lymph node dissection, etc.). For this reason, we think that MRI cognitive + systematic biopsy should be performed in patients with suspected PCa.

Keywords

• prostate cancer
• prostate biopsy
• MRI cognitive prostate biopsy
• gleason score

References

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