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Prostate Cancer
Volume 2014, Article ID 781438, 8 pages
http://dx.doi.org/10.1155/2014/781438
Clinical Study

Comparison of Transperineal Mapping Biopsy Results with Whole-Mount Radical Prostatectomy Pathology in Patients with Localized Prostate Cancer

1Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
2Urology Department, Western Health, Gordon Street, Footscray, VIC 3011, Australia
3Men’s Health Melbourne, Centre for Specialist Men’s Health and Fertility, Level M, 233 Collins Street, Melbourne, VIC 3000, Australia
4Department of Urology, Clinica Alemana, Avenida Manquehue Norte 1410, Vitacura, Santiago, Chile
5Cadence Health, Central Dupage Hospital, 25 North Winfield Road, Winfield, IL 60190, USA
6Baylor College of Medicine Medical Center, 7200 Cambridge Street, Suite 10B, Houston, TX 77030, USA
7Department of Pathology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
8Department of Urology, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga 849-8501, Japan
9Minas Gerais Federal University, Avenida Alfredo Balena 110, 30130-100 Belo Horizonte, MG, Brazil
10Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
11Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA

Received 28 December 2013; Accepted 5 March 2014; Published 11 May 2014

Academic Editor: Judd Moul

Copyright © 2014 Darren J. Katz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. We sought to evaluate the accuracy of transperineal mapping biopsy (TMB) by comparing it to the pathology specimen of patients who underwent radical prostatectomy (RP) for localized prostate cancer. Methods. From March 2007 to September 2009, 78 men at a single center underwent TMB; 17 of 78 subsequently underwent RP. TMB cores were grouped into four quadrants and matched to data from RP whole-mount slides. Gleason score, tumor location and volume, cross-sectional area, and maximal diameter were measured; sensitivity and specificity were assessed. Results. For the 17 patients who underwent RP, TMB revealed 12 (71%) had biopsy Gleason grades ≥ 3 + 4 and 13 (76%) had bilateral disease. RP specimens showed 14 (82%) had Gleason scores ≥ 3 + 4 and 13 (76%) had bilateral disease. Sensitivity and specificity of TMB for prostate cancer detection were 86% (95% confidence interval [CI] 72%–94%) and 83% (95% CI 62%–95%), respectively. Four quadrants negative for cancer on TMB were positive on prostatectomy, and six positive on TMB were negative on prostatectomy. Conclusion. TMB is a highly invasive procedure that can accurately detect and localize prostate cancer. These findings help establish baseline performance characteristics for TMB and its utility for organ-sparing strategies.