J Cancer 2018; 9(19):3634-3639. doi:10.7150/jca.26791

Research Paper

Risk of upgrading from prostate biopsy to radical prostatectomy pathology: Is magnetic resonance imaging-guided biopsy more accurate?

Ning Xu*, Yu-Peng Wu*, Xiao-Dong Li*, Min-Yi Lin, Qing-Shui Zheng, Shao-Hao Chen, Jun-Feng Li, Yong Wei, Xue-Yi Xue

Departments of Urology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
*These three authors contributed equally to this work.

Abstract

Background: This study compared magnetic resonance imaging-guided biopsy (MRI-GB) and transrectal ultrasound guided biopsy (TRUS-GB) with the final histology of the radical prostatectomy (RP) specimen.

Methods: Our subjects were 229 patients with prostate cancer (PCa), proven histopathologically using MRI-GB or TRUS-GB, who underwent RP at our center between December 2015 and December 2016. The main group included 92 patients who underwent MRI-GB and the control group included 137 patients who underwent 12-core TRUS-GB. Histological findings for RP specimens were compared with those from biopsies. We also evaluated predictors of upgraded Gleason score (GS), using uni- and multivariate analyses.

Results: Upgraded GS between biopsy and RP specimen occurred to 22.7% (52/229) of the cohort overall. In univariate analysis, prostate-specific antigen density (PSAD) (P<0.001), prostate volume (PV) < 30 ml (P<0.001), biopsy modality (P=0.027), biopsy GS (P=0.032) and measured MRI lymph node metastasis (P=0.018) were prognostic factors. Multivariate logistic regression analysis showed PV < 30 ml (P<0.001) and biopsy modality (P=0.001) were independent predictors of upgraded GS.

Conclusions: MRI-GB may enhance the diagnostic accuracy of prostate cancer detection in final histopathology with lower rate of upgraded GS than TRUS-GB. Also, PV < 30 ml and biopsy modality were independent predictors of upgraded GS.

Keywords: MRI, prostate biopsy, prostatectomy specimen, systematic biopsy, Gleason score upgrading.

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How to cite this article:
Xu N, Wu YP, Li XD, Lin MY, Zheng QS, Chen SH, Li JF, Wei Y, Xue XY. Risk of upgrading from prostate biopsy to radical prostatectomy pathology: Is magnetic resonance imaging-guided biopsy more accurate?. J Cancer 2018; 9(19):3634-3639. doi:10.7150/jca.26791. Available from http://www.jcancer.org/v09p3634.htm