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World Journal of Urology
Published in: World Journal of Urology 2/2020

01-02-2020 | Prostate Cancer | Original Article

Active surveillance outcomes in prostate cancer patients: the use of transperineal template-guided mapping biopsy for patient selection

Authors: Gregory S. Merrick, Ava Tennant, Ryan Fiano, Abbey Bennett, Richard Anderson, Robert Galbreath, Wayne M. Butler, Edward Adamovich

Published in: World Journal of Urology | Issue 2/2020

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Abstract

Purpose

To evaluate active surveillance (AS) outcomes including overall survival (OS), freedom from distant metastases (FDM), freedom from therapeutic intervention (FTI), and quality of life (QOL) outcomes in prostate cancer patients using transperineal template-guided mapping biopsy (TTMB) for patient selection.

Methods

From April 2005–January 2016, 226 consecutive, prospectively evaluated prostate cancer patients underwent TTMB for either low-grade prostate cancer or persistently elevated prostate-specific antigen (PSA) and/or the presence of ASAP. Evaluated outcomes included OS, FDM, FTI and QOL including urinary, bowel, sexual function and depression. Repeat biopsy was based on PSA kinetics and/or abnormal digital rectal examination.

Results

Of the 226 patients, 212 (93.8%) were Gleason 3 + 3 and 14 (6.2%) were Gleason 3 + 4. The median follow-up was 5.0 years (range 0.8–13.0 years). The mean prostate volume was 61.3 cm3 with a mean of 59.5 TTMB cores/patient. At the time of AS enrollment, an average of 72.9 cores (TRUS + TTMB) had been obtained for each patient. At 8 years, OS, FTI and FDM were 92.5, 96.8 and 100%. Two hundred and twenty-two patients (98.2%) had a PSA doubling time of more than 3 years. No statistical changes in urinary function, bowel function or depression were noted. At 8 years, 73% of the patients maintained erectile function.

Conclusion

Within the confines of the follow-up of this study, the use of TTMB for patient selection identifies a cohort of patients unlikely to develop biochemical or clinical progression and maintain a favorable quality of life.
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Metadata
Title
Active surveillance outcomes in prostate cancer patients: the use of transperineal template-guided mapping biopsy for patient selection
Authors
Gregory S. Merrick
Ava Tennant
Ryan Fiano
Abbey Bennett
Richard Anderson
Robert Galbreath
Wayne M. Butler
Edward Adamovich
Publication date
01-02-2020
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 2/2020
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-019-02695-w

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