Comparison of the Upgrading Rates of International Society of Urological Pathology Grades and Tumor Laterality in Patients Undergoing Standard 12-Core Prostate Biopsy versus Fusion Prostate Biopsy for Prostate Cancer.

BACKGROUND

Histopathological discrepancies between biopsy and radical prostatectomy (RP) specimens may lead to unnecessary, excessive, or incomplete treatment in prostate cancer (PCa) patients.

OBJECTIVES

To compare the upgrading rates of International Society of Urological Pathology (ISUP) grades and tumor laterality in patients that underwent standard 12-core transrectal ultrasound-guided standard prostate biopsy (SPB) versus multiparametric magnetic resonance-guided fusion prostate biopsy (FPB) for PCa.

METHODS

This retrospective study included 152 patients that underwent prostate biopsy and RP in our clinic. The patients were divided into 2 groups: Group A (n = 90) included patients that underwent SPB and Group B (n = 62) included patients that underwent FPB (targeted biopsy + standard biopsy). Upgrading of ISUP grades, tumor laterality, and upgrading of tumor laterality were compared between the 2 groups. Upgrading of tumor laterality defined as detection of tumor at both lobes in RP pathology while it was at unilateral lobe in biopsy pathology.

RESULTS

ISUP grade 1 was the most common histopathology in both groups. The ISUP upgrading rate on final pathology was significantly lower in the FPB group compared to the SPB group (22.7 vs. 37.7%; p < 0.048). Similarly, the upgrading rate of tumor laterality was lower in the FPB group compared to the SPB group (37.7 vs. 9.7%; p < 0.001).

CONCLUSION

The results suggested that FPB can provide more accurate results compared to SPB.