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1. Risk of Gleason Score 3+4=7 prostate cancer upgrading at radical prostatectomy is significantly reduced by targeted versus standard biopsy.

Author

De Luca S, Fiori C, Bollito E, Garrou D, Aimar R, Cattaneo G, De Cillis S, Manfredi M, Tota D, Federica M, Passera R, and Porpiglia F

Subjects
Adenocarcinoma pathology, Aged, Humans, Laparoscopy, Magnetic Resonance Imaging, Male, Middle Aged, Prospective Studies, Prostatic Neoplasms diagnostic imaging, Risk Reduction Behavior, Robotic Surgical Procedures, Sensitivity and Specificity, Treatment Outcome, Ultrasonography, Biopsy methods, Neoplasm Grading, Prostatectomy, Prostatic Neoplasms pathology, Prostatic Neoplasms surgery
Abstract

Background: The aim of this study is to evaluate if multiparametric magnetic resonance (mpMRI)-transrectal ultrasound (TRUS) fusion targeted biopsy (TBx) versus untargeted standard biopsy (SBx) may decrease the rate of pathological upgrading of Gleason Score (GS) 3+4 prostate cancer (PCa) at radical prostatectomy (RP). We also evaluated the impact of percent pattern 4 and cribriform glands at biopsy in the risk of GS 3+4=7 upgrading., Methods: A total of 301 patients with GS 3+4 PCa on biopsy (159 SBx and 142 TBx) who underwent laparoscopic robot-assisted RP were sequentially enrolled. Histological data from RP sections were used as reference standard. The concordance of biopsy with pathological GS, as well as the GS 3+4 upgrading at RP were evaluated in different univariate and multivariate binary logistic regression models, testing age, PSA, fPSA%, tumor volume, PI-RADS, clinical stage, percentage of Gleason pattern 4 (GP) and/or presence of cribriform sub-type at biopsy., Results: Of the 301 biopsies, the median of GP 4 was 16% of the tissue. Minimal GP 4 (≤16%) cancers had a significant lower median volume (1.7 mL) than those with GP4 >16% (2.9 mL), (P<0.001). Pathological GS 3+4 was confirmed for 58.8% and 82.2% for SBx and TBx patients, respectively. The rate of upgraded and downgraded GS on SBx versus TBx was 38.8% vis. 16.7% and 1.8% and 2.1%, respectively. The rate of upgrading was significantly associated with the presence of GP4 >16% versus ≤16% (OR 4.4, 95% CI 1.4-12.0; P=0.021) and with the presence of cribriform sub-type at biopsy specimens (OR 6.2, 95% CI 2.2-18.7; P<0.001)., Conclusions: We demonstrated that TBx technique significantly reduced the risk of GS 3+4 upgrading at RP, compared to SBx one. The rate of upgrading was significantly associated with GP4>16%, mostly when cribriform sub-type was present at biopsy specimens.

Published
2020
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2. EditorialReply to Anwar R. Padhani, Ivo G. Schoots, Jelle O. Barentsz. Fast Magnetic Resonance Imaging as a Viable Method for Directing the Prostate Cancer Diagnostic Pathway. Eur Urol Oncol 2021;4:863-5 Fast-MRI Feasibility in Biopsy-naive Patients: Clarifications on the Study Methods and Results

Author

Russo, Filippo, Mazzetti, Simone, Regge, Daniele, Ambrosini, Ilaria, Giannini, Valentina, Manfredi, Matteo, De Luca, Stefano, Bollito, Enrico, and Porpiglia, Francesco

Subjects
Biopsy, Feasibility Studies, Humans, Magnetic Resonance Imaging, Male, Prostatic Neoplasms, Research Design
Published
2021

3. Pros-IT CNR: an Italian prostate cancer monitoring project

Author

Noale, Marianna, Maggi, Stefania, Artibani, Walter, Bassi, Pier Francesco, Bertoni, Filippo, Bracarda, Sergio, Conti, Giario Natale, Corvo', RENZO GIACINTO, Gacci, Mauro, Graziotti, Pierpaolo, Magrini, Stefano Maria, Maurizi Enrici, Riccardo, Mirone, Vincenzo, Montironi, Rodolfo, Muto, Giovanni, Pecoraro, Stefano, Porreca, Angelo, Ricardi, Umberto, Tubaro, Andrea, Zagonel, Vittorina, Zattoni, Filiberto, Crepaldi, Gaetano, Corvò, Renzo, Alitto, Anna Rita, Ambrosi, Enrica, Antonelli, Alessandro, Aristei, Cynthia, Barbieri, Michele, Bardari, Franco, Bardoscia, Lilia, Barra, Salvina, Bartoncini, Sara, Basso, Umberto, Becherini, Carlotta, Bellavita, Rita, Bergamaschi, Franco, Berlingheri, Stefania, Berruti, Alfredo, Borghesi, Marco, Bortolus, Roberto, Borzillo, Valentina, Bosetti, Davide, Bove, Giuseppe, Bove, Pierluigi, Brausi, Maurizio, Bruni, Alessio, Bruno, Giorgio, Brunocilla, Eugenio, Buffoli, Alberto, BUGLIONE DI MONALE E BASTIA, Michela, Buttigliero, Consuelo, Cacciamani, Giovanni, Caldiroli, Michela, Cardo, Giuseppe, Carmignani, Giorgio, Carrieri, Giuseppe, Castelli, Emanuele, Castrezzati, Elisabetta, Catalano, Gianpiero, Cattarino, Susanna, Catucci, Francesco, Cavallini Francolini, Dario, Ceccarini, Ofelia, Celia, Antonio, Chiancone, Francesco, Chini, Tommaso, Cianci, Claudia, Cisternino, Antonio, Collura, Devis, Corbella, Franco, Corinti, Matteo, Corsi, Paolo, Cortese, Fiorenza, Corti, Luigi, de Nunzio, Cosimo, Cristiano, Olga, D'Angelillo, Rolando, Da Pozzo, Luigi, D'Agostino, Daniele, D’Andrea, David, Dandrea, Matteo, De Angelis, Michele, De Cobelli, Ottavio, De Concilio, Bernardino, De Lisa, Antonello, De Luca, Stefano, De Stefani, Agostina, Deantoni, Chiara Lucrezia, Degli Esposti, Claudio, Destito, Anna, Detti, Beatrice, Di Muzio, Nadia, Di Stasio, Andrea, Di Stefano, Calogero, Di Trapani, Danilo, Difino, Giuseppe, Falivene, Sara, Farullo, Giuseppe, Fedelini, Paolo, Ferrari, Ilaria, Ferrau, Francesco, Ferro, Matteo, Fodor, Andrei, Fontana, Francesco, Francesca, Francesco, Giulio, Francolini, Frata, Paolo, Frezza, Giovanni, Gabriele, Pietro, Galeandro, Maria, Garibaldi, Elisabetta, Gennari, Pietro, Gentilucci, Alessandro, Giacobbe, Alessandro, Giussani, Laura, Giusti, Giuseppe, Gontero, Paolo, Guarneri, Alessia, Guida, Cesare, Gurioli, Alberto, Huqi, Dorijan, Imbimbo, Ciro, Ingrosso, Gianluca, Iotti, Cinzia, Italia, Corrado, La Mattina, Pierdaniele, Lamanna, Enza, Lastrucci, Luciana, Lazzari, Grazia, Liberale, Fabiola, Liguori, Giovanni, Lisi, Roberto, Lohr, Frank, Lombardo, Riccardo, Lovisolo, Jon, Ludovico, Giuseppe Mario, Macchione, Nicola, Maggio, Francesca, Malizia, Michele, Manasse, Gianluca, Mandoliti, Giovanni, Mantini, Giovanna, Marafioti, Luigi, Marciello, Luisa, Marconi, Alberto Mario, Martillotta, Antonietta, Marzano, Salvino, Masciullo, Stefano, Maso, Gloria, Massenzo, Adele, Mazzeo, Ercole, Mearini, Luigi, Medoro, Serena, Molè, Rosa, Monesi, Giorgio, Montanari, Emanuele, Montefiore, Franco, Montesi, Giampaolo, Morgia, Giuseppe, Moro, Gregorio, Muscas, Giorgio, Musio, Daniela, Muto, Paolo, Muzzonigro, Giovanni, Napodano, Giorgio, Negro, Carlo Luigi Augusto, Nidini, Mattia, Ntreta, Maria, Orsatti, Marco, Palazzolo, Carmela, Palumbo, Isabella, Parisi, Alessandro, Parma, Paolo, Pavan, Nicola, Pericolini, Martina, Pinto, Francesco, Pistone, Antonio, Pizzuti, Valerio, Platania, Angelo, Polli, Caterina, Pomara, Giorgio, Ponti, Elisabetta, Porcaro, Antonio Benito, Porpiglia, Francesco, Pugliese, Dario, Pycha, Armin, Raguso, Giuseppe, Rampini, Andrea, Randone, Donato Franco, Roscigno, Marco, Ruggieri, Maria Paola, Ruoppo, Giuseppe, Sanseverino, Roberto, Santacaterina, Anna, Santarsieri, Michele, Santoni, Riccardo, Scagliarini, Sarah, Scagliotti, Giorgio Vittorio, Scanzi, Mauro, Scarcia, Marcello, Schiavina, Riccardo, Sciarra, Alessandro, Sciorio, Carmine, Scolaro, Tindaro, Scuzzarella, Salvatore, Selvaggio, Oscar, Serao, Armando, Serni, Sergio, Signor, Marco Andrea, Silvani, Mauro, Silvano, Giovanni, Silvestris, Franco, Simeone, Claudio, Simone, Valeria, Spagnoletti, Girolamo, Spinelli, Matteo Giulio, Squillace, Luigi, Tombolini, Vincenzo, Toninelli, Mariastella, Triggiani, Luca, Trinchieri, Alberto, Trodella, Luca Eolo, Trodella, Lucio, Trombetta, Carlo, Tronnolone, Lidia, Tucci, Marcello, Urzì, Daniele, Valdagni, Riccardo, Valeriani, Maurizio, Vanoli, Maurizio, Vitali, Elisabetta, Zaramella, Stefano, Zeccolini, Guglielmo, Zini, Giampaolo, Marianna Noale, Stefania Maggi, Walter Artibani, Pier Francesco Bassi, Filippo Bertoni, Sergio Bracarda, Giario Natale Conti, Renzo Corvò, Mauro Gacci, Pierpaolo Graziotti, Stefano Maria Magrini, Riccardo Maurizi Enrici, Vincenzo Mirone, Rodolfo Montironi, Giovanni Muto, Stefano Pecoraro, Angelo Porreca, Umberto Ricardi, Andrea Tubaro, Vittorina Zagonel, Filiberto Zattoni, Gaetano Crepaldi, the Pros-IT CNR study group: [.., Marco Borghesi, Eugenio Brunocilla, Riccardo Schiavina, ], Noale, M, Maggi, S, Artibani, W, Bassi, P, Bertoni, F, Bracarda, S, Conti, G, Corvò, R, Gacci, M, Graziotti, P, Magrini, S, Maurizi Enrici, R, Mirone, V, Da Pozzo, L, and Pros-IT CNR study, G, Noale, Marianna, Maggi, Stefania, Artibani, Walter, Bassi, Pier Francesco, Bertoni, Filippo, Bracarda, Sergio, Conti, Giario Natale, Corvò, Renzo, Gacci, Mauro, Graziotti, Pierpaolo, Magrini, Stefano Maria, Maurizi Enrici, Riccardo, Mirone, Vincenzo, Montironi, Rodolfo, Muto, Giovanni, Pecoraro, Stefano, Porreca, Angelo, Ricardi, Umberto, Tubaro, Andrea, Zagonel, Vittorina, Zattoni, Filiberto, Crepaldi, Gaetano, Alitto, Anna Rita, Ambrosi, Enrica, Antonelli, Alessandro, Aristei, Cynthia, Barbieri, Michele, Bardari, Franco, Bardoscia, Lilia, Barra, Salvina, Bartoncini, Sara, Basso, Umberto, Becherini, Carlotta, Bellavita, Rita, Bergamaschi, Franco, Berlingheri, Stefania, Berruti, Alfredo, Borghesi, Marco, Bortolus, Roberto, Borzillo, Valentina, Bosetti, Davide, Bove, Giuseppe, Bove, Pierluigi, Brausi, Maurizio, Bruni, Alessio, Bruno, Giorgio, Brunocilla, Eugenio, Buffoli, Alberto, Buglione, Michela, Buttigliero, Consuelo, Cacciamani, Giovanni, Caldiroli, Michela, Cardo, Giuseppe, Carmignani, Giorgio, Carrieri, Giuseppe, Castelli, Emanuele, Castrezzati, Elisabetta, Catalano, Gianpiero, Cattarino, Susanna, Catucci, Francesco, Cavallini Francolini, Dario, Ceccarini, Ofelia, Celia, Antonio, Chiancone, Francesco, Chini, Tommaso, Cianci, Claudia, Cisternino, Antonio, Collura, Devi, Corbella, Franco, Corinti, Matteo, Corsi, Paolo, Cortese, Fiorenza, Corti, Luigi, de Nunzio, Cosimo, Cristiano, Olga, D’Angelillo, Rolando, Da Pozzo, Luigi, D’Agostino, Daniele, D’Andrea, David, Dandrea, Matteo, De Angelis, Michele, De Cobelli, Ottavio, De Concilio, Bernardino, De Lisa, Antonello, De Luca, Stefano, De Stefani, Agostina, Deantoni, Chiara Lucrezia, Degli Esposti, Claudio, Destito, Anna, Detti, Beatrice, Di Muzio, Nadia, Di Stasio, Andrea, Di Stefano, Calogero, Di Trapani, Danilo, Difino, Giuseppe, Falivene, Sara, Farullo, Giuseppe, Fedelini, Paolo, Ferrari, Ilaria, Ferrau, Francesco, Ferro, Matteo, Fodor, Andrei, Fontana, Francesco, Francesca, Francesco, Giulio, Francolini, Frata, Paolo, Frezza, Giovanni, Gabriele, Pietro, Galeandro, Maria, Garibaldi, Elisabetta, Gennari, Pietro, Gentilucci, Alessandro, Giacobbe, Alessandro, Giussani, Laura, Giusti, Giuseppe, Gontero, Paolo, Guarneri, Alessia, Guida, Cesare, Gurioli, Alberto, Huqi, Dorijan, Imbimbo, Ciro, Ingrosso, Gianluca, Iotti, Cinzia, Italia, Corrado, La Mattina, Pierdaniele, Lamanna, Enza, Lastrucci, Luciana, Lazzari, Grazia, Liberale, Fabiola, Liguori, Giovanni, Lisi, Roberto, Lohr, Frank, Lombardo, Riccardo, Lovisolo, Jon, Ludovico, Giuseppe Mario, Macchione, Nicola, Maggio, Francesca, Malizia, Michele, Manasse, Gianluca, Mandoliti, Giovanni, Mantini, Giovanna, Marafioti, Luigi, Marciello, Luisa, Marconi, Alberto Mario, Martillotta, Antonietta, Marzano, Salvino, Masciullo, Stefano, Maso, Gloria, Massenzo, Adele, Mazzeo, Ercole, Mearini, Luigi, Medoro, Serena, Molè, Rosa, Monesi, Giorgio, Montanari, Emanuele, Montefiore, Franco, Montesi, Giampaolo, Morgia, Giuseppe, Moro, Gregorio, Muscas, Giorgio, Musio, Daniela, Muto, Paolo, Muzzonigro, Giovanni, Napodano, Giorgio, Negro, Carlo Luigi Augusto, Nidini, Mattia, Ntreta, Maria, Orsatti, Marco, Palazzolo, Carmela, Palumbo, Isabella, Parisi, Alessandro, Parma, Paolo, Pavan, Nicola, Pericolini, Martina, Pinto, Francesco, Pistone, Antonio, Pizzuti, Valerio, Platania, Angelo, Polli, Caterina, Pomara, Giorgio, Ponti, Elisabetta, Porcaro, Antonio Benito, Porpiglia, Francesco, Pugliese, Dario, Pycha, Armin, Raguso, Giuseppe, Rampini, Andrea, Randone, Donato Franco, Roscigno, Marco, Ruggieri, Maria Paola, Ruoppo, Giuseppe, Sanseverino, Roberto, Santacaterina, Anna, Santarsieri, Michele, Santoni, Riccardo, Scagliarini, Sarah, Scagliotti, Giorgio Vittorio, Scanzi, Mauro, Scarcia, Marcello, Schiavina, Riccardo, Sciarra, Alessandro, Sciorio, Carmine, Scolaro, Tindaro, Scuzzarella, Salvatore, Selvaggio, Oscar, Serao, Armando, Serni, Sergio, Signor, Marco Andrea, Silvani, Mauro, Silvano, Giovanni, Silvestris, Franco, Simeone, Claudio, Simone, Valeria, Spagnoletti, Girolamo, Spinelli, Matteo Giulio, Squillace, Luigi, Tombolini, Vincenzo, Toninelli, Mariastella, Triggiani, Luca, Trinchieri, Alberto, Trodella, Luca Eolo, Trodella, Lucio, Trombetta, Carlo, Tronnolone, Lidia, Tucci, Marcello, Urzì, Daniele, Valdagni, Riccardo, Valeriani, Maurizio, Vanoli, Maurizio, Vitali, Elisabetta, Zaramella, Stefano, Zeccolini, Guglielmo, Zini, Giampaolo, Noale, M., Maggi, S., Artibani, W., Bassi, P. F., Bertoni, F., Bracarda, S., Conti, G. N., Corvo, R., Gacci, M., Graziotti, P., Magrini, S. M., Maurizi Enrici, R., Mirone, V., Montironi, R., Muto, G., Pecoraro, S., Porreca, A., Ricardi, U., Tubaro, A., Zagonel, V., Zattoni, F., Crepaldi, G., Alitto, A. R., Ambrosi, E., Antonelli, A., Aristei, C., Barbieri, M., Bardari, F., Bardoscia, L., Barra, S., Bartoncini, S., Basso, U., Becherini, C., Bellavita, R., Bergamaschi, F., Berlingheri, S., Berruti, A., Borghesi, M., Bortolus, R., Borzillo, V., Bosetti, D., Bove, G., Bove, P., Brausi, M., Bruni, A., Bruno, G., Brunocilla, E., Buffoli, A., Buglione, M., Buttigliero, C., Cacciamani, G., Caldiroli, M., Cardo, G., Carmignani, G., Carrieri, G., Castelli, E., Castrezzati, E., Catalano, G., Cattarino, S., Catucci, F., Cavallini Francolini, D., Ceccarini, O., Celia, A., Chiancone, F., Chini, T., Cianci, C., Cisternino, A., Collura, D., Corbella, F., Corinti, M., Corsi, P., Cortese, F., Corti, L., de Nunzio, C., Cristiano, O., D'Angelillo, R., Da Pozzo, L., D'Agostino, D., D'Andrea, D., Dandrea, M., De Angelis, M., De Cobelli, O., De Concilio, B., De Lisa, A., De Luca, S., De Stefani, A., Deantoni, C. L., Degli Esposti, C., Destito, A., Detti, B., Di Muzio, N., Di Stasio, A., Di Stefano, C., Di Trapani, D., Difino, G., Falivene, S., Farullo, G., Fedelini, P., Ferrari, I., Ferrau, F., Ferro, M., Fodor, A., Fontana, F., Francesca, F., Giulio, F., Frata, P., Frezza, G., Gabriele, P., Galeandro, M., Garibaldi, E., Gennari, P., Gentilucci, A., Giacobbe, A., Giussani, L., Giusti, G., Gontero, P., Guarneri, A., Guida, C., Gurioli, A., Huqi, D., Imbimbo, C., Ingrosso, G., Iotti, C., Italia, C., La Mattina, P., Lamanna, E., Lastrucci, L., Lazzari, G., Liberale, F., Liguori, G., Lisi, R., Lohr, F., Lombardo, R., Lovisolo, J., Ludovico, G. M., Macchione, N., Maggio, F., Malizia, M., Manasse, G., Mandoliti, G., Mantini, G., Marafioti, L., Marciello, L., Marconi, A. M., Martillotta, A., Marzano, S., Masciullo, S., Maso, G., Massenzo, A., Mazzeo, E., Mearini, L., Medoro, S., Mole, R., Monesi, G., Montanari, E., Montefiore, F., Montesi, G., Morgia, G., Moro, G., Muscas, G., Musio, D., Muto, P., Muzzonigro, G., Napodano, G., Negro, C. L. A., Nidini, M., Ntreta, M., Orsatti, M., Palazzolo, C., Palumbo, I., Parisi, A., Parma, P., Pavan, N., Pericolini, M., Pinto, F., Pistone, A., Pizzuti, V., Platania, A., Polli, C., Pomara, G., Ponti, E., Porcaro, A. B., Porpiglia, F., Pugliese, D., Pycha, A., Raguso, G., Rampini, A., Randone, D. F., Roscigno, M., Ruggieri, M. P., Ruoppo, G., Sanseverino, R., Santacaterina, A., Santarsieri, M., Santoni, R., Scagliarini, S., Scagliotti, G. V., Scanzi, M., Scarcia, M., Schiavina, R., Sciarra, A., Sciorio, C., Scolaro, T., Scuzzarella, S., Selvaggio, O., Serao, A., Serni, S., Signor, M. A., Silvani, M., Silvano, G., Silvestris, F., Simeone, C., Simone, V., Spagnoletti, G., Spinelli, M. G., Squillace, L., Tombolini, V., Toninelli, M., Triggiani, L., Trinchieri, A., Trodella, L. E., Trodella, L., Trombetta, C., Tronnolone, L., Tucci, M., Urzi, D., Valdagni, R., Valeriani, M., Vanoli, M., Vitali, E., Zaramella, S., Zeccolini, G., and Zini, G.

Subjects
Italian UCLA Cancer Index, Prostate cancer, Prostate cancer treatments, Quality of life, SF-12 Scale, Adult, Aged, Biopsy, Disease Management, Health Status, Humans, Italy, Male, Middle Aged, Neoplasm Staging, Prospective Studies, Prostatic Neoplasms, Quality of Life, Aging, Geriatrics and Gerontology, medicine.medical_specialty, 03 medical and health sciences, 0302 clinical medicine, medicine, 030212 general & internal medicine, Risk factor, Disease management (health), Prospective cohort study, Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA, Cancer staging, business.industry, medicine.disease, Clinical trial, Prostate cancer, Monitoring, Survival, Outcomes, Settore MED/24, Prostate cancer treatment, 030220 oncology & carcinogenesis, Family medicine, Physical therapy, Observational study, business
Abstract

Aims: The Pros-IT CNR project aims to monitor a sample of Italian males ≥18years of age who have been diagnosed in the participating centers with incident prostate cancer, by analyzing their clinical features, treatment protocols and outcome results in relation to quality of life. Methods: Pros-IT CNR is an observational, prospective, multicenter study. The National Research Council (CNR), Neuroscience Institute, Aging Branch (Padua) is the promoting center. Ninety-seven Italian centers located throughout Italy were involved. The field study began in September 1, 2014. Subjects eligible were diagnosed with biopsy-verified prostate cancer, naïve. A sample size of 1500 patients was contemplated. A baseline assessment including anamnestic data, clinical history, risk factors, the initial diagnosis, cancer staging information and quality of life (Italian UCLA Prostate Cancer Index; SF-12 Scale) was completed. Six months after the initial diagnosis, a second assessment evaluating the patient’s health status, the treatment carried out, and the quality of life will be made. A third assessment, evaluating the treatment follow-up and the quality of life, will be made 12months after the initial diagnosis. The 4th, 5th, 6th and 7th assessments, similar to the third, will be completed 24, 36, 48 and 60months after the initial diagnosis, respectively, and will include also a Food Frequency Questionnaire and the Physical Activity Scale for the Elderly. Discussion: The study will provide information on patients’ quality of life and its variations over time in relation to the treatments received for the prostate cancer.

Published
2017

4. Multiparametric Magnetic Resonance/Ultrasound Fusion Prostate Biopsy: Number and Spatial Distribution of Cores for Better Index Tumor Detection and Characterization.

Author

Porpiglia, Francesco, De Luca, Stefano, Passera, Roberto, De Pascale, Agostino, Amparore, Daniele, Cattaneo, Giovanni, Checcucci, Enrico, De Cillis, Sabrina, Garrou, Diletta, Manfredi, Matteo, Mele, Fabrizio, Bollito, Enrico, and Fiori, Cristian

Subjects
PROSTATE biopsy, PROSTATE, PROSTATE tumors, RECTUM examination, GLEASON grading system, DIAGNOSIS, MAGNETIC resonance imaging
Abstract

Purpose We evaluated the minimum core number for better index tumor detection to determine the best core site as well as biopsy Gleason score heterogeneity in the same index lesion. The aim was to optimize the highest Gleason score detection. Materials and Methods A total of 327 patients with negative digital rectal examination underwent magnetic resonance imaging/transrectal ultrasound fusion targeted biopsy for elevated/rising prostate specific antigen and/or 1 or more detectable lesions on multiparametric magnetic resonance imaging after a previous negative standard biopsy. Depending on the diameter of each index lesion (8 or less, or greater than 8 mm) 4 or 6 cores, respectively, were taken according to a well determined sequence. Results Of the patients 166 (50.7%) had prostate cancer, including 79 (47.6%) with an 8 mm or less index lesion and 87 (52.4%) with a greater than 8 mm index lesion. Of patients with an index tumor 8 mm or less 7 (8.9%) had 1, 31 (39.2%) had 2, 27 (34.2%) had 3 and 14 (17.7%) had 4 positive cores. Similarly, of patients with a lesion greater than 8 mm 8 (9.2%) had 1, 30 (34.5%) had 2, 13 (14.9%) had 3, 14 (16.1%) had 4, 12 (13.8%) had 5 and 10 (11.5%) had 6 positive cores. The major prevalence of positive cores was observed in the center of the target. Gleason score heterogeneity was found in 12.6% of those with an 8 mm or less target vs 26.4% with a target greater than 8 mm. In the center of the target there was a slight prevalence of Gleason pattern 4 or greater, or a lesser pattern. Conclusions Approaching magnetic resonance imaging/transrectal ultrasound fusion targeted biopsy with a single core might be inadequate. Rather, taking 2 cores in the center of the index lesion may provide more accurate cancer detection and optimize the chances of finding the highest Gleason pattern. [ABSTRACT FROM AUTHOR]

Published
2017
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5. High prostate cancer gene 3 ( PCA3) scores are associated with elevated Prostate Imaging Reporting and Data System ( PI- RADS) grade and biopsy Gleason score, at magnetic resonance imaging/ultrasonography fusion software-based targeted prostate biopsy after a previous negative standard biopsy

Author

De Luca, Stefano, Passera, Roberto, Cattaneo, Giovanni, Manfredi, Matteo, Mele, Fabrizio, Fiori, Cristian, Bollito, Enrico, Cirillo, Stefano, and Porpiglia, Francesco

Subjects
*PROSTATE cancer, *CANCER genes, *GLEASON grading system, *PROSTATE-specific antigen, *MAGNETIC resonance imaging, *BIOPSY
Abstract

Objective To determine the association among prostate cancer gene 3 ( PCA3) score, Prostate Imaging Reporting and Data System ( PI- RADS) grade and Gleason score, in a cohort of patients with elevated prostate-specific antigen ( PSA), undergoing magnetic resonance imaging/ultrasonography fusion software-based targeted prostate biopsy ( TBx) after a previous negative randomised 'standard' biopsy ( SBx). Patients and Methods In all, 282 patients who underwent TBx after previous negative SBx and a PCA3 urine assay, were enrolled. The associations between PCA3 score/ PI- RADS and PCA3 score/Gleason score were investigated by K-means clustering, a receiver operating characteristic analysis and binary logistic regression. Results The PCA3 score difference for the negative vs positive TBx cohorts was highly statistically significant. A 1-unit increase in the PCA3 score was associated to a 2.4% increased risk of having a positive TBx result. A PCA3 score of >80 and a PI- RADS grade of ≥4 were independent predictors of a positive TBx. The association between the PCA3 score and PI- RADS grade was statistically significant (the median PCA3 score for PI- RADS grade groups 3, 4, and 5 was 58, 104, and 146, respectively; P = 0.006). A similar pattern was detected for the relationship between the PCA3 score and Gleason score; an increasing PCA3 score was associated with a worsening Gleason score (median PCA3 score equal to 62, 105, 132, 153, 203, and 322 for Gleason Score 3+4, 4+3, 4+4, 4+5, 5+4, and 5+5, respectively; P < 0.001). Conclusion TBx improved PCA3 score diagnostic and prognostic performance for prostate cancer. The PCA3 score was directly associated both with biopsy Gleason score and PI- RADS grade: notably, in the 'indeterminate' PI- RADS grade 3 subgroup. [ABSTRACT FROM AUTHOR]

Published
2016
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6. Head-to-Head Comparison of Prostate Health Index and Urinary PCA3 for Predicting Cancer at Initial or Repeat Biopsy.

Author

Scattoni, Vincenzo, Lazzeri, Massimo, Lughezzani, Giovanni, De Luca, Stefano, Passera, Roberto, Bollito, Enrico, Randone, Donato, Abdollah, Firas, Capitanio, Umberto, Larcher, Alessandro, Lista, Giuliana, Gadda, Giulio Maria, Bini, Vittorio, Montorsi, Francesco, Guazzoni, Giorgio, Diaz, Mireya, and MarksL, Leonard S.

Subjects
BIOPSY, DIAGNOSIS, PROSTATE cancer, LOGISTIC regression analysis, PERFORMANCE evaluation, CLINICAL trials, COMPARATIVE studies
Abstract

Purpose: We performed a head-to-head comparison of the PHI (Prostate Health Index) and PCA3. Materials and Methods: We evaluated PHI and PCA3 performance in 211 patients undergoing initial (116) or repeat (95) prostate biopsy. Multivariable logistic regression analysis was done using the AUC to test the accuracy of PHI and PCA3 for predicting prostate cancer in the overall population and in each setting. Decision curve analysis was used to compare the clinical benefit of different models. Results: Overall, the AUC of the PHI (0.70) was significantly higher than the AUC of PCA3 (0.59), total prostate specific antigen (0.56) and free-to-total prostate specific antigen (0.60) (p = 0.043, 0.002 and 0.037, respectively). PHI was more accurate than PCA3 for predicting prostate cancer in the initial setting (AUC 0.69 vs 0.57) and in the repeat setting (AUC 0.72 vs 0.63), although no statistically significant difference was observed. Including PCA3 in the base multivariable model (prostate specific antigen plus free-to-total prostate specific antigen plus prostate volume) did not increase predictive accuracy in either setting (AUC 0.79 vs 0.80 and 0.75 vs 0.76, respectively). Conversely, including PHI in the base multivariable model improved predictive accuracy by 5% (AUC 0.79 to 0.84) and 6% (AUC 0.75 to 0.81) in the initial and repeat prostate biopsy settings, respectively. On decision curve analysis the highest net benefit was observed when PHI was added to the base multivariable model. Conclusions: PHI and PCA3 provide a significant increase in sensitivity and specificity compared to all other examined markers and they may help guide biopsy decisions. PCA3 does not increase the accuracy of predicting prostate cancer when PHI is assessed. [ABSTRACT FROM AUTHOR]

Published
2013
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7. Histological chronic prostatitis and high-grade prostate intra-epithelial neoplasia do not influence urinary prostate cancer gene 3 score.

Author

De Luca, Stefano, Passera, Roberto, Milillo, Angela, Coda, Renato, and Randone, Donato Franco

Subjects
*PROSTATITIS, *PROSTATE cancer, *PROSTATE-specific antigen, *DIGITAL rectal examination, *BIOPSY, *BENIGN prostatic hyperplasia
Abstract

Objective To determine whether histological chronic prostatitis and high-grade prostate intra-epithelial neoplasia ( HG-PIN) influence the prostate cancer gene 3 ( PCA3) score in Italian patients with an elevated prostate-specific antigen ( PSA) level and a negative digital rectal examination ( DRE) who were undergoing a first or repeat prostate biopsy., Patients and Methods A urinary PCA3 test was prospectively performed in 432 consecutive patients who were admitted to Gradenigo Hospital ( Turin, Italy) between January and December 2011 and scheduled for first or repeat prostate biopsy as a result of an elevated PSA level and negative DRE., A comparison of the PCA3 score and patients with a negative biopsy (normal parenchyma, benign prostatic hyperplasia, chronic prostatitis, HG-PIN) or positive biopsy was performed., Results PCA3 median (range) scores varied significantly ( P < 0.001) in men with a negative vs positive biopsy : 33 (2-212) and 66 (5-324), respectively., By contrast, men with chronic prostatitis and HG-PIN showed no significant difference with respect to PCA3 score compared to other negative biopsy patients., No correlation was found between the number of positive cores for chronic prostatitis, HG-PIN and PCA3 score., Of all patients with a positive biopsy, 23 (20%) of 114 men had a PCA3 score ≤35., In total, 79 (40%) of 197 men with a negative biopsy (normal parenchyma and benign prostatic hyperplasia), 24 (37.5%) of 64 men with chronic prostatitis and 19 (39.6%) of 48 men with HG-PIN had a PCA3 score >35., Conclusion At this early stage of clinical evaluation, cancer specificity of the urinary PCA3 test appears to be maintained in the face of chronic prostatitis and HG-PIN. [ABSTRACT FROM AUTHOR]

Published
2012
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8. Prostate cancer biomarkers: new scenarios in the multi-parametric magnetic resonance imaging era.

Author

Porpiglia, Francesco and De Luca, Stefano

Subjects
*PROSTATE cancer, *DIAGNOSIS, *MAGNETIC resonance imaging, *BIOPSY, *PROSTATE cancer risk factors, *PROSTATECTOMY
Abstract

The article discusses the benefits of multi-parametric magnetic resonance imaging (mpMRI) in detecting the clinical manifestation for prostate cancer. However, mpMRI is expensive, labor-intensive and time-consuming reporting, and is not feasible for screening purposes in men at risk of prostate cancer. The authors believe that both prostatectomy and fusion biopsy remain preferable in evaluating diagnostic accuracy of prostate cancer biomarkers.

Published
2017
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