Regional Versus Systematic Biopsy in Addition to Targeted Biopsy : Results from a Systematic Review and Meta-analysis
Sanguedolce, Francesco (Institut de Recerca Sant Pau)
Lauwers, C.N.G. (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Tedde, A. (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Basile, G. (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Chernysheva, D. (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Uleri, A. (IRCCS - Humanitas Research Hospital)
Baboudjian, Michael (North Academic Hospital. AP-HM)
Giannarini, G. (Santa Maria della Misericordia Academic Medical Centre)
Panebianco, V. (Università degli Studi di Roma "La Sapienza")
Madonia, M. (Universitá degli Studi di Sassari)
Budäus, L. (University Hospital Hamburg-Eppendorf)
Roupret, M. (Sorbonne University)
Palou, Juan (Institut de Recerca Sant Pau)
Breda, Alberto (Institut de Recerca Sant Pau)
Schoots, I. (Erasmus MC University Medical Centre)
Padhani, A.R. (Mount Vernon Hospital)
Universitat Autònoma de Barcelona. Departament de Medicina

Data:	2025
Resum:	BACKGROUND AND OBJECTIVE: Intensification of targeted biopsy (TBx) around a magnetic resonance imaging (MRI)-visible lesion with regional biopsy (RBx) could obviate the need for systematic biopsy (SBx). We aimed to compare the detection yields of clinically significant prostate cancer (csPCa)-defined as International Society of Urological Pathology (ISUP) grade group ≥2-between TBx + RBx and the reference standard (TBx + SBx). METHODS: RBx was defined as perilesional or ipsilateral biopsy. A literature search was conducted up to September 2023 using PubMed, Embase, and Web of Science databases. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. Included studies were eligible when presenting data from SBx, TBx, and TBx + RBx cores and their detection yields. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) criteria were used to assess the risk of bias of the included studies. KEY FINDINGS AND LIMITATIONS: Twenty-one studies were included for a meta-analysis. The overall detection yield of csPCa was not statistically different between TBx + SBX and TBx + RBx (46. 1% vs 44. 2%; odds ratio [OR] 1. 07, 95% confidence interval [CI] 0. 99-1. 16, p = 0. 07); similar findings were found also for ISUP grade group ≥3 prostate cancer (PCa; OR 1. 06, 95% CI 0. 92-1. 22, p = 0. 43) and in different subgroup analyses. TBx + SBx was associated with higher cancer detection of ISUP grade group 1 PCa (OR 1. 16, 95% CI 1. 04-1. 30, p = 0. 008). The main limitations include the retrospective nature of most of the selected studies, heterogeneity of RBx definition, and template. CONCLUSIONS AND CLINICAL IMPLICATIONS: Our study supports the use of the TBx + RBx template in the early detection pathway for the detection of csPCa. SBx can be omitted when targeting lesions visible on MRI. PATIENT SUMMARY: A prostate biopsy strategy consisting of taking biopsy in and around an magnetic resonance imaging-visible lesion reduces the risk of detecting indolent prostate cancers without affecting the detection of aggressive tumours.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Clinically significant prostate cancer ; Prostate magnetic resonance imaging ; Regional targeted prostate biopsy ; Systematic prostate biopsy ; Targeted prostate biopsy
Publicat a:	European urology oncology, Vol. 8 Núm. 2 (january 2025) , p. 534-543, ISSN 2588-9311

DOI: 10.1016/j.euo.2024.10.006
PMID: 39455339

10 p, 1.9 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut de Recerca Sant Pau
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