Clinical utility of transperineal template-guided mapping prostate biopsy in a selection of patients under active surveillance and confirmation of patients with negative biopsy for prostate cancer

PurposeWe investigated the change to definitive treatment in patients under active surveillance (AS) and cancer diagnosis in non-cancerous patients for prostate cancer after confirmatory transperineal template-guided mapping biopsy (TTMB).Materials and methodsA total of 336 patients who underwent TT...

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Main Authors: Michael Jakun Koo, Byunghun Lee, Wan Song, Minyong Kang, Hyun Hwan Sung, Byong Chang Jeong, Seong Il Seo, Seong Soo Jeon, Chung Un Lee, Hwang Gyun Jeon
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2024.1403237/full
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author Michael Jakun Koo
Byunghun Lee
Wan Song
Minyong Kang
Hyun Hwan Sung
Byong Chang Jeong
Seong Il Seo
Seong Soo Jeon
Chung Un Lee
Hwang Gyun Jeon
author_facet Michael Jakun Koo
Byunghun Lee
Wan Song
Minyong Kang
Hyun Hwan Sung
Byong Chang Jeong
Seong Il Seo
Seong Soo Jeon
Chung Un Lee
Hwang Gyun Jeon
author_sort Michael Jakun Koo
collection DOAJ
description PurposeWe investigated the change to definitive treatment in patients under active surveillance (AS) and cancer diagnosis in non-cancerous patients for prostate cancer after confirmatory transperineal template-guided mapping biopsy (TTMB).Materials and methodsA total of 336 patients who underwent TTMB between March 2017 and March 2023 were retrospectively reviewed, with 134 AS patients and 202 non-cancerous patients. All patients were routinely followed up via prostate-specific antigen (PSA) and multiparametric magnetic resonance imaging (mpMRI), and follow-up biopsy was performed when deemed clinically appropriate. Treatment changes in the AS and cancer detection in the non-cancerous group were analyzed. Descriptive statistics were used to analyze the retrospective data, and the Kaplan–Meier analysis was performed to indicate conversion to radical treatment in the AS group, as well as cancer detection in the previously benign non-cancerous group.ResultsOne hundred thirty-four patients under the AS protocol were analyzed, of whom 110 (82.1%) maintained AS for 33 months. Nine patients (6.7%) had significant findings in mpMRI [Prostate Imaging–Reporting and Data System (PI-RADS) ≥3] and received radical treatment following target biopsy via transrectal ultrasonography. A total of 115 patients (83.3%) with insignificant findings in mpMRI (PI-RADS 1 or 2 lesions) were followed up via transrectal ultrasound-guided prostate biopsy (17.4%, N = 20), repeat TTMB (6.1%, N = 7), or no additional biopsy (76.5%, N = 88), and from each group, five (25.0%), two (28.5%), and eight (9.1%) patients converted to radical treatment. In the non-cancerous group, five patients (2.5%) were diagnosed with prostate cancer, with PI-RADS ≥ 3 findings via mpMRI, and were confirmed by target biopsy during a mean follow-up period of 25 months, subsequently receiving radical treatment.ConclusionsTTMB is effective in selecting patients for AS treatment and confirming benign patients and can be used as an effective follow-up modality.
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spelling doaj-art-90e0099feb734187bca4d6e3dc3318452025-08-20T02:06:22ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-03-011410.3389/fonc.2024.14032371403237Clinical utility of transperineal template-guided mapping prostate biopsy in a selection of patients under active surveillance and confirmation of patients with negative biopsy for prostate cancerMichael Jakun Koo0Byunghun Lee1Wan Song2Minyong Kang3Hyun Hwan Sung4Byong Chang Jeong5Seong Il Seo6Seong Soo Jeon7Chung Un Lee8Hwang Gyun Jeon9Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Urology, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Gyeonggi-do, Republic of KoreaDepartment of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaPurposeWe investigated the change to definitive treatment in patients under active surveillance (AS) and cancer diagnosis in non-cancerous patients for prostate cancer after confirmatory transperineal template-guided mapping biopsy (TTMB).Materials and methodsA total of 336 patients who underwent TTMB between March 2017 and March 2023 were retrospectively reviewed, with 134 AS patients and 202 non-cancerous patients. All patients were routinely followed up via prostate-specific antigen (PSA) and multiparametric magnetic resonance imaging (mpMRI), and follow-up biopsy was performed when deemed clinically appropriate. Treatment changes in the AS and cancer detection in the non-cancerous group were analyzed. Descriptive statistics were used to analyze the retrospective data, and the Kaplan–Meier analysis was performed to indicate conversion to radical treatment in the AS group, as well as cancer detection in the previously benign non-cancerous group.ResultsOne hundred thirty-four patients under the AS protocol were analyzed, of whom 110 (82.1%) maintained AS for 33 months. Nine patients (6.7%) had significant findings in mpMRI [Prostate Imaging–Reporting and Data System (PI-RADS) ≥3] and received radical treatment following target biopsy via transrectal ultrasonography. A total of 115 patients (83.3%) with insignificant findings in mpMRI (PI-RADS 1 or 2 lesions) were followed up via transrectal ultrasound-guided prostate biopsy (17.4%, N = 20), repeat TTMB (6.1%, N = 7), or no additional biopsy (76.5%, N = 88), and from each group, five (25.0%), two (28.5%), and eight (9.1%) patients converted to radical treatment. In the non-cancerous group, five patients (2.5%) were diagnosed with prostate cancer, with PI-RADS ≥ 3 findings via mpMRI, and were confirmed by target biopsy during a mean follow-up period of 25 months, subsequently receiving radical treatment.ConclusionsTTMB is effective in selecting patients for AS treatment and confirming benign patients and can be used as an effective follow-up modality.https://www.frontiersin.org/articles/10.3389/fonc.2024.1403237/fullprostate canceractive surveillancetransperineal biopsymultiparametric MRItransrectal ultrasound guided biopsy
spellingShingle Michael Jakun Koo
Byunghun Lee
Wan Song
Minyong Kang
Hyun Hwan Sung
Byong Chang Jeong
Seong Il Seo
Seong Soo Jeon
Chung Un Lee
Hwang Gyun Jeon
Clinical utility of transperineal template-guided mapping prostate biopsy in a selection of patients under active surveillance and confirmation of patients with negative biopsy for prostate cancer
Frontiers in Oncology
prostate cancer
active surveillance
transperineal biopsy
multiparametric MRI
transrectal ultrasound guided biopsy
title Clinical utility of transperineal template-guided mapping prostate biopsy in a selection of patients under active surveillance and confirmation of patients with negative biopsy for prostate cancer
title_full Clinical utility of transperineal template-guided mapping prostate biopsy in a selection of patients under active surveillance and confirmation of patients with negative biopsy for prostate cancer
title_fullStr Clinical utility of transperineal template-guided mapping prostate biopsy in a selection of patients under active surveillance and confirmation of patients with negative biopsy for prostate cancer
title_full_unstemmed Clinical utility of transperineal template-guided mapping prostate biopsy in a selection of patients under active surveillance and confirmation of patients with negative biopsy for prostate cancer
title_short Clinical utility of transperineal template-guided mapping prostate biopsy in a selection of patients under active surveillance and confirmation of patients with negative biopsy for prostate cancer
title_sort clinical utility of transperineal template guided mapping prostate biopsy in a selection of patients under active surveillance and confirmation of patients with negative biopsy for prostate cancer
topic prostate cancer
active surveillance
transperineal biopsy
multiparametric MRI
transrectal ultrasound guided biopsy
url https://www.frontiersin.org/articles/10.3389/fonc.2024.1403237/full
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