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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Genitourinary Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1403237
This article is part of the Research Topic Advancing Approaches in Treating Genitourinary Cancers: Evolving Paradigms of Minimally-Invasive Interventions View all articles

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

Provisionally accepted
Michael Jakun Koo Michael Jakun Koo 1Byunghun Lee Byunghun Lee 1*Wan Song Wan Song 1Minyong Kang Minyong Kang 1*Hyun Hwan Sung Hyun Hwan Sung 1*Byong Chang Jeong Byong Chang Jeong 1*Seong Il Seo Seong Il Seo 1*Seong Soo Jeon Seong Soo Jeon 1*Chung Un Lee Chung Un Lee 2*Hwang Gyun Jeon Hwang Gyun Jeon 1*
  • 1 Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
  • 2 Chung-Ang University, Seoul, Seoul, Republic of Korea

The final, formatted version of the article will be published soon.

    We 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 prostate biopsy (TTMB). Materials and Methods We retrospectively reviewed 336 patients who underwent TTMB between March 2017 and March 2023, 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 non-cancerous groups were analyzed. Descriptive statistics were used to analyze the retrospective data, and Kaplan-Meier analysis was performed to indicate conversion to radical treatment in AS group, as well as cancer-detection on previously benign non-cancerous group. Results One hundred and thirty-four patients under the AS protocol were analyzed, of which 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. Totally, 115 patients (83.3%) with insignificant findings in mpMRI (PI-RADS 1 or 2 lesions) were followed up with transrectal ultrasound-guided prostate biopsy (17.4%, N = 20), repeat TTMB (6.1%, N = 7), or no additional biopsy (76.5%, N = 88), and five (25.0%), two (28.5%), and eight (9.1%) patients converted to radical treatment from each group, respectively. 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. Conclusions TTMB is effective in selecting patients for AS treatment, confirming benign patients, and can be used as an effective follow-up modality.

    Keywords: prostate cancer, active surveillance, transperineal biopsy, Multiparametric MRI, transrectal ultrasound guided biopsy

    Received: 22 Mar 2024; Accepted: 03 Oct 2024.

    Copyright: © 2024 Koo, Lee, Song, Kang, Sung, Jeong, Seo, Jeon, Lee and Jeon. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Byunghun Lee, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
    Minyong Kang, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
    Hyun Hwan Sung, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
    Byong Chang Jeong, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
    Seong Il Seo, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
    Seong Soo Jeon, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
    Chung Un Lee, Chung-Ang University, Seoul, 156-756, Seoul, Republic of Korea
    Hwang Gyun Jeon, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.