Introduction:
The aim of this study is to examine if guided prostate biopsies based on abnormalities detected by conventional and functional endorectal magnetic resonance imaging (mri) yield a more reliable representation of the radical prostatectomy pathology and to identify probable preoperative clinical variables that stratified patients likely to harbor significant upgrading.
Patients and methods:
From april 2004 to april 2009, a review of n=70 patients records diagnosed with prostate cancer by a 3-6 core guided transrectal ultrasound (trus) prostate biopsy based on abnormalities detected by conventional and functional endorectal mri and who subsequently underwent radical prostatectomy and exhibited a significant upgrading was conducted. additionally, a multivariate analysis with a significant upgrading as the outcome was performed including the following parameters: prostate specific antigen (psa) level, clinical stage, prostate size and duration from biopsy to radical prostatectomy.
Results:
A significant upgrading was noted in only 8.5% of patients, with 1.4% exhibiting a significant downgrading and the rest 90.1% exhibiting an exact gleason score match. no preoperative clinical variables that stratified patients likely to harbour significant upgrading were identified.
Conclusions:
This type of biopsy method seems to solve the discordance between the biopsy gleason score and radical prostatectomy pathology regardless of known preoperative clinical variables that can affect it.