Cancer - Prostate(구연) (E-129)

The Clinical Utility of Transperineal Template-Guided Saturation Prostate Biopsy for Risk Stratification After Transrectal Ultrasound-Guided Biopsy
성균관대학교 의과대학 비뇨기과학교실
전황균, 성시현, 송완, 정재훈, 강민용, 성현환, 정병창, 서성일, 전성수, 이현무
목적: To investigate the clinical utility of transperineal template-guided saturation prostate biopsy (TPB) for risk stratification after transrectal ultrasound (TRUS)-guided biopsy.
대상 및 방법: We retrospectively reviewed 430 patients who underwent TPB after previously negative results on TRUS-guided biopsy (n=174) or who were candidates for active surveillance (n=256) fulfilling the PRIAS criteria between May 2017 and May 2020. The patients' clinicopathologic data were reviewed, and the detection of clinically significant cancer (CSC, defined as Gleason grade 3+4 or greater) and upgrading of Gleason grade were identified.
결과: The patients' median age and pre-TPB prostate-specific antigen (PSA) value were 64.0 years and 7.77 ng/mL, respectively. Of the 174 males with a previous negative result on TRUS-guided biopsy, prostate cancer (PCa) was detected in 43 males (25.0%), including 15 males (8.6%) with CSC. Of the 256 patient candidates for active surveillance, upgrading of the Gleason grade was identified in 69 males (26.9%), 60 with a Gleason grade of 7 and 9 with a Gleason grade of 8. Of the total 256 patients candidates for AS, 125 (48.8%) patients remained on AS, 35 (13.7%) patients underwent HIFU treatment, and 96 (37.5%) patients underwent radical treatment (radical prostatectomy, radiotherapy, hormone therapy) after TPB.
결론: TPB helps to stratify the risk of PCa that was previously missed or underdiagnosed by TRUS-guided biopsy. TPB might be used as a diagnostic tool to determine risk classification and to help counsel patients with regard to treatment decisions.
keywords : Prostate cancer, Biopsy, Active surveillance