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Number №4, 2021 - page 30-36

Characteristics of prostate cancer detected during primary (systematic) and repeated prostate biopsy and its assessment after radical prostatectomy DOI: 10.29188/2222-8543-2021-14-4-30-36

For citation: Chibichian M.B., Avetyan A.V., Belousov I.I., Lapteva T.O., Ilyash A.V., Glukhov V.P. Characteristics of prostate cancer detected during primary (systematic) and repeated prostate biopsy and its assessment after radical prostatectomy. Experimental and Clinical Urology, 2021;14(4):30-36; https://doi.org/10.29188/2222-8543-2021-14-4-30-36
Chibichian M.B., Avetyan A.V., Belousov I.I., Lapteva T.O., Ilyash A.V., Glukhov V.P.
Information about authors:
  • Chibichian M.B. – Dr.Sc. (Med), Assoc.Prof. (Docent); Assoc. Prof., Dept. of Urology and Human Reproductive Health with Pediatric Urology and Andrology Course, Rostov State Medical University; Rostov-on-Don, Russia; https://orcid.org/0000-0003-2765-7910
  • Avetyan A.V. – postgraduate student, Dept. of Urology and Human Reproductive Health (with Pediatric Urology and Andrology Course), Rostov State Medical University; Rostov-on-Don, Russia; https://orcid.org/0000-0001-7748-0039
  • Belousov I.I. – Dr. Sc., Professor, Dept. of Urology and Human Reproductive Health (with Pediatric Urology and Andrology Course), Rostov State Medical University; Rostov-on-Don, Russia; https://orcid.org/0000-0003-0674-9429
  • Lapteva T.O. – a pathologist of the highest category, head of the pathological department of the FSBI RNIOI of the Ministry of Health of Russia; Rostov-on-Don, Russia; https://orcid.org/0000-0002-6544-6113
  • Ilyash A.V. – PhD Assist., Dept. of Urology and Human Reproductive Health (with the Pediatric Urology and Andrology Course), Rostov State Medical University; Rostov-on-Don, Russia; https://orcid.org/0000-0001-8433-8567
  • Glukhov V.P. – PhD Assoc.Prof. (Docent); Assoc. Prof., Dept. of Urology and Human Reproductive Health (with the Pediatric Urology and Andrology Сourse), Rostov State Medical University; Rostov-on-Don, Russia; https://orcid.org/0000-0002-8486-9357
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Introduction. When diagnosing prostate cancer (PCa) in 20–40% of patients, more than one prostate biopsy (BP) is required. The incidence of PCa in recurrent BP is 20%.

Purpose of the study. To identify the differences in prostate cancer detected in primary and recurrent BP.

Materials and methods. The study included 44 patients with prostate cancer. Group I consisted of 19 men with PCa detected in recurrent BP (medians: age – 60 years, PSA – 9.9 ng / ml, prostate volume – 44.3 cm3 , tumor in biopsy – 15%). A lesion in the prostate, according to transrectal ultrasonography (TRUS), was detected in 26% of patients, PIN 3 – in 20%, cT1a – in 5.3%, cT1b – in 26.3%, T1c – in 21.0%, cT2 – at 47.4%. Group II included 25 men with prostate cancer detected in primary BP (medians: age – 63 years, PSA – 7.1 ng / ml, prostate volume – 38 cm3 , tumor in biopsy – 40%). A lesion in the prostate with TRUS was detected in 68% of patients, PIN 3 – in 20%, stage cT1c – in 76.0%, cT2 – in 24.0%. Radical prostatectomy was performed in 15 patients: 7 in group I and 8 in group II. After morphological studying of removed prostate in group I, stage pT2a was detected in 57.1% of patients, pT2b – in 14.3%, pT2c – in 28.6%, invasion of prostate cancer into the capsule of the gland – in 28.6%. Group ISUP-1 corresponded to 14% of patients, ISUP-2 – 43%, ISUP ≥ 3 – 43%. After evaluation of the drug in group II, stage pT2a was detected in 12.5% of patients, pT2c – in 87.5%, prostate cancer invasion into the glandular capsule – in 9%, ISUP ≥ 3 – in 100%.

Results. Comparison of the groups revealed differences in the volume of the tumor in the biopsy specimen (p = 0.005), the criterion for the involvement of the gland capsule in the tumor process (p = 0.007), the proportion of patients with a focus on TRUS (p = 0.01) with the prevalence of these signs in group II. The groups were comparable in pT stage, ISUP and lesion volume in the gland preparation (p> 0.05).

Conclusion. The low efficiency of primary PD is due to the shortcomings of its randomness and low accuracy. The absence of PCa in systemic PD is not a sign of a small tumor in the gland. Protate cancer detected during repeated PD is quite aggressive.

 

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prostate gland; prostate; prostate cancer (PCa); biopsy of the prostate (BP); PIN 3

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