Initial outcomes of local anaesthetic freehand transperineal prostate biopsies in the outpatient setting.
Adult
Aged
Aged, 80 and over
Ambulatory Surgical Procedures
Anesthetics, Local
/ therapeutic use
Humans
Image-Guided Biopsy
Lidocaine
/ therapeutic use
Magnetic Resonance Imaging, Interventional
Male
Middle Aged
Outpatients
Perineum
/ pathology
Prospective Studies
Prostate
/ pathology
Prostate-Specific Antigen
/ blood
Prostatic Neoplasms
/ diagnostic imaging
#PCSM
#Prostate Cancer
#uroonc
complications
histology
prostate biopsy
transperineal
transrectal
Journal
BJU international
ISSN: 1464-410X
Titre abrégé: BJU Int
Pays: England
ID NLM: 100886721
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
pubmed:
16
11
2018
medline:
7
7
2020
entrez:
16
11
2018
Statut:
ppublish
Résumé
To evaluate the histopathological outcomes, morbidity and tolerability of freehand transperineal (TP) prostate biopsies using the PrecisionPoint™ access system (Perineologic, Cumberland, MD, USA) under local anaesthetic (LA) in the day surgery and outpatient environments, as systematic and targeted biopsies can be taken with the potential for reduced morbidity, particularly sepsis. In all, 176 patients underwent freehand TP prostate biopsies from May 2016 to November 2017. The procedure was carried out either under LA alone or with the addition of sedation. Magnetic resonance imaging (MRI) scans were reported using the Prostate Imaging-Reporting and Data System (PI-RADS), version 2. Tolerability was assessed using a visual analogue scale pain score for each procedural stage. Histopathological outcomes and complications were recorded. The mean (range) age was 65 (36-83) years, median (range) prostate-specific antigen level was 7.9 (0.7-1374) ng/mL, and the mean (range) prostate volume 45 (15-157) mL. Biopsies were taken under LA alone (160 patients, 90%) or under LA with sedation (16, 9%). The main indication for biopsy was primary diagnosis (88.6%). In all, 91 (52%) patients underwent systematic TP biopsies (mean 24.2 cores). Cognitive MRI-targeted biopsies alone were performed in 45 patients (26%; mean 6.8 cores), and 40 (23%) had both systematic and target biopsies (mean 27.9 cores). Of the 75 patients who had primary systematic biopsies alone, 46 (61%) were positive, and 28/46 (60.9%) were diagnosed with clinically significant disease (Gleason ≥3+4). VAS pain scores were greatest during LA administration. There were five complications (2.8%, Clavien-Dindo Grade I/II). No patients developed urosepsis. Freehand TP biopsies using the PrecisionPoint access system is a safe, tolerable and effective method for systematic and targeted biopsies under LA in the outpatient setting. It has replaced transrectal biopsies in our centre and has potential to transform practice.
Substances chimiques
Anesthetics, Local
0
Lidocaine
98PI200987
Prostate-Specific Antigen
EC 3.4.21.77
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
244-252Informations de copyright
© 2018 The Authors BJU International © 2018 BJU International.
Références
Yeo L, Patel D, Bach C et al. The development of the modern prostate biopsy. In: Bissada NK ed., Prostate Biopsy. Rijeka, Croatia: InTech, 2011: 1-19
Heidenreich A, Bellmunt J, Bolla M et al. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol 2011; 59: 61-71
Heidenreich A, Bastian PJ, Bellmunt J et al. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent-update 2013. Eur Urol 2014; 65: 124-37
NICE. Suspected cancer: recognition and referral, 2017. Available at: https://www.nice.org.uk/guidance/ng12/chapter/1-recommendations-organised-by-site-of-cancer#urological-cancers. Accessed July 2018
National Institute for Health and Care Excellence. Prostate cancer: diagnosis and management [CG175]. 2014. Available at: nice.org.uk/guidance/cg175. Accessed November 2017
Ahmed HU, El-Shater Bosaily A, Brown LC et al. Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet 2017; 389: 815-22
Kasivisvanathan V, Rannikko AS, Borghi M et al. MRI-targeted or standard biopsy for prostate-cancer diagnosis. N Engl J Med 2018; 378: 1767-77
Batura D, Gopal Rao G. The national burden of infections after prostate biopsy in England and Wales: a wake-up call for better prevention. J Antimicrob Chemother 2013; 68: 247-9
Vyas L, Acher PF, Kinsella JF et al. Indications, results and safety profile of transperineal sector biopsies (TPSB) of the prostate: a single centre experience of 634 cases. BJU Int 2014; 114: 32-7
Grummet J, Pepdjonovic L, Huang S, Anderson E, Hadaschik B. Transperineal vs. transrectal biopsy in MRI targeting. Transl Androl Urol 2017; 6: 368-75
Hansen N, Patruno G, Wadhwa K et al. Magnetic resonance and ultrasound image fusion supported transperineal prostate biopsy using the Ginsburg protocol: technique, learning points, and biopsy results. Eur Urol 2016; 70: 332-40
Eldred-Evans D, Kasivisvanathan V, Khan F et al. The use of transperineal sector biopsy as a first-line biopsy strategy: a multi-institutional analysis of clinical outcomes and complications. Urol J 2016; 13: 2849-55
Presti JC Jr. Prostate biopsy strategies. Nat Clin Pract Urol 2007; 4: 505-11
Acher P, Dooldeniya M. Prostate biopsy: will transperineal replace transrectal? BJU Int 2013; 112: 533-4
Bott SR, Henderson A, Halls JE, Montgomery BS, Laing R, Langley SE. Extensive transperineal template biopsies of prostate: modified technique and results. Urology 2006; 68: 1037-41
Abdulmajed MI, Hughes DF, Shergill IS. The role of transperineal template biopsies of the prostate in the diagnosis of prostate cancer: a review. Expert Rev Med Devices 2015; 12: 175-82
Jones JS, Patel AF, Schoenfield L, Rabets JC, Zippe CD, Magi-Galluzzi C. Saturation technique does not improve cancer detection as an initial prostate biopsy strategy. J Urol 2006; 175: 485-8
Zaytoun OM, Jones JS. Prostate cancer detection after a negative prostate biopsy: lessons learnt in the Cleveland Clinic experience. Int J Urol 2011; 18: 557-68
Mabjeesh NJ, Lidawi GF, Chen JF, German LF, Matzkin H. High detection rate of significant prostate tumours in anterior zones using transperineal ultrasound-guided template saturation biopsy. BJU Int 2012; 110: 993-7
Moore CM, Robertson NL, Arsanious N et al. Image-guided prostate biopsy using magnetic resonance imaging-derived targets: a systematic review. Eur Urol 2013; 63: 125-40
Pepe P, Aragona F. Morbidity after transperineal prostate biopsy in 3000 patients undergoing 12 vs 18 vs more than 24 needle cores. Urology 2013; 81: 1142-6
Loeb S, Vellekoop A, Ahmed HU et al. Systematic review of complications of prostate biopsy. Eur Urol 2013; 64: 876-92
Thurtle D, Starling L, Leonard K, Stone T, Gnanapragasam VJ. Improving the safety and tolerability of local anaesthetic outpatient transperineal prostate biopsies: a pilot study of the CAMbridge PROstate Biopsy (CAMPROBE) method. J Clin Urol 2018; 11: 192-9
Smith JB, Popert R, Nuttall MC, Vyas L, Kinsella J, Cahill D. Transperineal sector prostate biopsies: a local anesthetic outpatient technique. Urology 2014; 83: 1344-9
Ashley RA, Inman BA, Routh JC et al. Preventing pain during office biopsy of the prostate: a single center, prospective, double-blind, 3-arm, parallel group, randomized clinical trial. Cancer 2010; 110: 1708-14
Meyer AR, Joice GA, Schwen ZR, Partin AW, Allaf ME, Gorin MA. Initial experience performing in-office ultrasound-guided transperineal prostate biopsy under local anesthesia using the precisionpoint transperineal access system. Urology 2018; 115: 8-13
Dundee PE, Grummet JP, Murphy DG. Transperineal prostate biopsy: template-guided or freehand? BJU Int 2015; 115: 681-3
Emiliozzi P, Maymone SF, Paterno AF et al. Increased accuracy of biopsy Gleason score obtained by extended needle biopsy. J Urol 2004; 172: 2224-6
Hara R, Jo YF, Fujii TF et al. Optimal approach for prostate cancer detection as initial biopsy: prospective randomized study comparing transperineal versus transrectal systematic 12-core biopsy. Urology 2008; 71: 191-5
Altok M, Ward J, Chapin B, Pisters L, Pettaway C, Davis J. Cost analysis of different prostate biopsy modalities. J Urol 2017; 197: e821