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Objectives: To evaluate the role of quantitative histologic findings in predicting nonorgan-confined (non-OC) prostate cancer (PCa) in patients undergoing saturation prostate biopsy (SPBx). Methods: A total of 69 patients who had undergone SPBx underwent radical retropubic prostatectomy. Their prostate-specific antigen level was <10 ng/mL, and 49 and 20 patients had T1c and T2 PCa, respectively. The following biopsy variables from the quantitative histologic examination were evaluated as predictive of OC vs non-OC PCa: Gleason score (≤6 vs >6), total percentage of PCa (≤20% vs >20%), greatest percentage of PCa (≤50% vs >50%), number of PCa-positive cores (≤2 vs >2), presence of PCa-positive cores in both lateral margins (yes vs no), and PCa localization (unilateral vs bilateral). The results obtained from patients who had undergone SPBx were compared with those of 183 patients who had undergone 12-core prostate biopsy before radical retropubic prostatectomy. Results: Overall, 32 patients had non-OC PCa. Among the men with Stage T1c PCa, the quantitative histologic findings were predictive of non-OC PCa in 12 of 17 cases. The area under the receiver operating characteristic curve was 0.935 ± 0.29, supporting the high accuracy of quantitative histologic examination in predicting for non-OC PCa. The sensitivity in patients who underwent SPBx vs the 12-core biopsy was 78.1% and 89.4%, respectively. Also, although the specificity of each histologic parameter was significantly lower in the SPBx group, it was equivalent using quantitative histologic examination (85.6% vs 86.5%). Conclusions: In the preoperative staging of patients with clinical Stage T1c-T2 PCa and a prostate-specific antigen level <10 ng/mL who had undergone SPBx, quantitative histologic examination demonstrated good accuracy in predicting for non-OC PCa only when all pathological variables were considered. [Copyright &y& Elsevier]

Objectives: To evaluate whether the adjunct of an ultrasound contrast medium improves the detection rate of prostate cancer.Method: In 34 patients, scheduled to undergo a trans-perineal extended prostate biopsy, we carried out a color-Doppler ultrasound (CDU) of the prostate before and after i.v. injection of Levovist®, an ultrasound contrast medium. Further bioptic samples were taken in the areas where a marked increase in vascularization was noticed.Results: The overall diagnostic sensitivity, specificity and efficiency were respectively 72.7, 56.2 and 62.9% for transrectal ultrasound (TRUS); 80, 56.2 and 65.3% for CDU and 88.8, 54.5 and 68% for CDU after Levovist® injection; 66.5, 72.6 and 65.1% for digito-rectal examination (DRE); 100, 51.4 and 65.4% for total PSA; and 100, 88.8 and 94.3% for PSA free/total. In the 16 patients with prostate carcinoma, the sensitivity of CDU after Levovist® was 92.3, 66% for both DRE and TRUS, and 80% for DRE plus TRUS.Conclusions: Considering the cost and the results obtained (high sensitivity and low specificity), a routine use of Levovist® does not seem indicated in patients undergoing prostatic biopsy. An exception may be represented by patients with both negative DRE and TRUS.Prostate Cancer and Prostatic Diseases (2003) 6, 159-162. doi:10.1038/sj.pcan.4500647 [ABSTRACT FROM AUTHOR]