Impact of prostate biopsy technique on outcomes of the precision prostatectomy procedure
Objective To assess the impact of iterative changes in preoperative and postoperative biopsy techniques on the outcomes of men undergoing the precision prostatectomy procedure. Precision prostatectomy is a novel surgical treatment for prostate cancer that aims to maximally preserve erectogenic nerve...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2022-10-01
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| Series: | BMJ Surgery, Interventions, & Health Technologies |
| Online Access: | https://sit.bmj.com/content/4/1/e000122.full |
| _version_ | 1797215253875916800 |
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| author | Akshay Sood Wooju Jeong Firas Abdollah Mani Menon Ralph Grauer Michael A. Gorin Mohit Butaney Phil Olson Guillaume Farah Renee Hanna Cole |
| author_facet | Akshay Sood Wooju Jeong Firas Abdollah Mani Menon Ralph Grauer Michael A. Gorin Mohit Butaney Phil Olson Guillaume Farah Renee Hanna Cole |
| author_sort | Akshay Sood |
| collection | DOAJ |
| description | Objective To assess the impact of iterative changes in preoperative and postoperative biopsy techniques on the outcomes of men undergoing the precision prostatectomy procedure. Precision prostatectomy is a novel surgical treatment for prostate cancer that aims to maximally preserve erectogenic nerves via partial preservation of the prostate capsule.Design Retrospective.Setting Single tertiary care center.Participants This study included 120 patients who consented to undergo prostate cancer treatment with the precision prostatectomy procedure. Patients were originally enrolled in one of two separate prospective protocols studying precision prostatectomy.Interventions Preoperatively, 60 patients were screened with transrectal (TR) biopsy and 60 were screened by transperineal (TP) biopsy. Ultimately, 117 patients underwent precision prostatectomy. Of the 43 postoperative biopsies, 19 were TR; 17 were TP with ultrasound; and 7 were TP with microultrasound (mUS).Main outcome measures Preoperatively, we evaluated whether the transition to TP biopsy was associated with differences in postoperative treatment failure defined as a neoplasm-positive postoperative biopsy. Postoperative biopsies were compared with respect to their ability to sample the remnant tissue, specifically percentage of cores positive for prostate tissue.Results Preoperatively, 9/60 (15%) positive postoperative biopsies occurred in the TR group and 6/60 (10%) in the TP group; Kaplan-Meier survival estimates did not differ between groups (p=0.69 by log rank). Postoperatively, the numbers of cores positive for prostate tissue were 99/160 (62%), 63/107 (59%), and 36/39 (92%) in the TR biopsy, TP with ultrasound, and TP with mUS groups, respectively; this difference was statistically significant versus the rate in the TR and standard TP groups (p=0.0003 and 0.0002).Conclusion We found no significant improvement in patient screening, preoperatively—though limited by small sample size and relatively short follow-up. The incorporation of high-frequency mUS for postoperative biopsies improved the ability to sample the remnant tissue with a higher efficiency. |
| first_indexed | 2024-04-24T11:27:08Z |
| format | Article |
| id | doaj.art-cda16d7274654c8ca8c4086c8048d411 |
| institution | Directory Open Access Journal |
| issn | 2631-4940 |
| language | English |
| last_indexed | 2024-04-24T11:27:08Z |
| publishDate | 2022-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Surgery, Interventions, & Health Technologies |
| spelling | doaj.art-cda16d7274654c8ca8c4086c8048d4112024-04-10T14:30:09ZengBMJ Publishing GroupBMJ Surgery, Interventions, & Health Technologies2631-49402022-10-014110.1136/bmjsit-2021-000122Impact of prostate biopsy technique on outcomes of the precision prostatectomy procedureAkshay Sood0Wooju Jeong1Firas Abdollah2Mani Menon3Ralph Grauer4Michael A. Gorin5Mohit Butaney6Phil Olson7Guillaume Farah8Renee Hanna Cole9Vattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan, USAVattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan, USAVattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan, USADepartment of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USADepartment of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USAUrology, Urology Associates and UPMC Western Maryland, Cumberland, Maryland, USAVattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan, USAVattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan, USAVattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan, USAVattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan, USAObjective To assess the impact of iterative changes in preoperative and postoperative biopsy techniques on the outcomes of men undergoing the precision prostatectomy procedure. Precision prostatectomy is a novel surgical treatment for prostate cancer that aims to maximally preserve erectogenic nerves via partial preservation of the prostate capsule.Design Retrospective.Setting Single tertiary care center.Participants This study included 120 patients who consented to undergo prostate cancer treatment with the precision prostatectomy procedure. Patients were originally enrolled in one of two separate prospective protocols studying precision prostatectomy.Interventions Preoperatively, 60 patients were screened with transrectal (TR) biopsy and 60 were screened by transperineal (TP) biopsy. Ultimately, 117 patients underwent precision prostatectomy. Of the 43 postoperative biopsies, 19 were TR; 17 were TP with ultrasound; and 7 were TP with microultrasound (mUS).Main outcome measures Preoperatively, we evaluated whether the transition to TP biopsy was associated with differences in postoperative treatment failure defined as a neoplasm-positive postoperative biopsy. Postoperative biopsies were compared with respect to their ability to sample the remnant tissue, specifically percentage of cores positive for prostate tissue.Results Preoperatively, 9/60 (15%) positive postoperative biopsies occurred in the TR group and 6/60 (10%) in the TP group; Kaplan-Meier survival estimates did not differ between groups (p=0.69 by log rank). Postoperatively, the numbers of cores positive for prostate tissue were 99/160 (62%), 63/107 (59%), and 36/39 (92%) in the TR biopsy, TP with ultrasound, and TP with mUS groups, respectively; this difference was statistically significant versus the rate in the TR and standard TP groups (p=0.0003 and 0.0002).Conclusion We found no significant improvement in patient screening, preoperatively—though limited by small sample size and relatively short follow-up. The incorporation of high-frequency mUS for postoperative biopsies improved the ability to sample the remnant tissue with a higher efficiency.https://sit.bmj.com/content/4/1/e000122.full |
| spellingShingle | Akshay Sood Wooju Jeong Firas Abdollah Mani Menon Ralph Grauer Michael A. Gorin Mohit Butaney Phil Olson Guillaume Farah Renee Hanna Cole Impact of prostate biopsy technique on outcomes of the precision prostatectomy procedure BMJ Surgery, Interventions, & Health Technologies |
| title | Impact of prostate biopsy technique on outcomes of the precision prostatectomy procedure |
| title_full | Impact of prostate biopsy technique on outcomes of the precision prostatectomy procedure |
| title_fullStr | Impact of prostate biopsy technique on outcomes of the precision prostatectomy procedure |
| title_full_unstemmed | Impact of prostate biopsy technique on outcomes of the precision prostatectomy procedure |
| title_short | Impact of prostate biopsy technique on outcomes of the precision prostatectomy procedure |
| title_sort | impact of prostate biopsy technique on outcomes of the precision prostatectomy procedure |
| url | https://sit.bmj.com/content/4/1/e000122.full |
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