You have accessJournal of UrologyProstate Cancer: Detection and Screening V1 Apr 20122201 DISCORDANCE RATES OF BIOPSY TECHNIQUES AMONG MEN WITH PROSTATE CANCER THAT ARE CANDIDATES FOR ACTIVE SURVEILLANCE Brian Linder, Igor Frank, Eric Umbreit, Mark Shimko, Nicolás Fernández, Laureano Rangel, and R. Jeffrey Karnes Brian LinderBrian Linder Rochester, MN More articles by this author , Igor FrankIgor Frank Rochester, MN More articles by this author , Eric UmbreitEric Umbreit Rochester, MN More articles by this author , Mark ShimkoMark Shimko Rochester, MN More articles by this author , Nicolás FernándezNicolás Fernández Rochester, MN More articles by this author , Laureano RangelLaureano Rangel Rochester, MN More articles by this author , and R. Jeffrey KarnesR. Jeffrey Karnes Rochester, MN More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2376AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES With the ongoing stage migration in the diagnosis of prostate cancer, there has been increased interest in management with active surveillance. Our study examines the ability of two prostate biopsy techniques to predict appropriate candidates for active surveillance. METHODS 500 consecutive patients, between 2005 and 2007, that underwent trans-rectal ultrasound guided biopsy by either an office biopsy with 12 cores or a saturation biopsy with ≥18 cores, and subsequent radical prostatectomy were identified. Using criteria of: Gleason score ≤6, clinical stage T1 or T2a, Prostate Specific Antigen (PSA) <10 and ≤33% of cores involved, 220 patients were found to be candidates for active surveillance. Pathology results from the prostatectomy specimens were used determine the discordance rate of each biopsy technique. RESULTS Of the 220 candidates for active surveillance, 124 patients underwent an office biopsy with 12 cores, and 96 patients underwent a saturation biopsy. The median number of cores in the saturation biopsy cohort was 27. There was no statistically significant difference between the groups in terms of median age (p=0.18), pre-operative PSA (p=0.48) and clinical stage (p=0.2). At least one previous negative biopsy had been performed on 20 patients (16%) in the office cohort and 43 patients (45%) in the saturation cohort (p= <0.001). In the 12 core biopsy group, 17 patients (14%) were upgraded to Gleason 7 on pathology from the prostatectomy specimen. In the saturation biopsy group, 14 patients (15%) were upgraded to Gleason 7, and 1 patient (1%) was upgraded to Gleason 8. There was no statistically significant difference in the rate of upgrading between the office and saturation biopsy cohorts (p=0.69). In the office biopsy group, 2 patients (1.6%) were upstaged to pT3 disease, compared to 0 patients (0%) in the saturation biopsy group (p=0.58). No statistically significant difference in the estimated tumor volume of the prostatectomy specimen was seen between the cohorts (p=0.47). CONCLUSIONS Candidates for active surveillance can accurately be predicted with 12 core biopsies. In both cohorts, approximately 1 in 6 patients underwent upgrading based on the pathology of the prostatectomy specimen. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e887 Peer Review Report Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Brian Linder Rochester, MN More articles by this author Igor Frank Rochester, MN More articles by this author Eric Umbreit Rochester, MN More articles by this author Mark Shimko Rochester, MN More articles by this author Nicolás Fernández Rochester, MN More articles by this author Laureano Rangel Rochester, MN More articles by this author R. Jeffrey Karnes Rochester, MN More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...