Marra G, et al. – The present study was to observe the accuracy of systematic transperineal sector mapping biopsy (TPSMB) in predicting Gleason score (GS) at radical prostatectomy (RP), to correlate its accuracy with standard transrectal ultrasound–guided biopsies (TRUS) and to establish the clinical impact of discordance between biopsies and RP on subsequent surgical management. It was showed taht TPSMB had a higher accuracy for predicting the GS grade at RP showing superior GS concordance compared with standard TRUS. TPSMB serves an feasible technique for systematic prostate biopsy to assess overall prostate cancer GS.

Methods

• In this retrospective multi–institutional study, between 2008 to 2013, clinicians recruited 255 patients who underwent RP following TPSMB (n = 204) or TRUS (n = 51).
• In this analysis, concordance between biopsies and RPs GS was evaluated both as percentages and with Cohen's Kappa coefficient.
• They evaluated all mismatches between biopsies and RP for significance by 3 urologists using the Delphi method.

Results

• There were no differences among the groups.
• They recorded that concordance between biopsy and RP GS was 75.49% for TPSMB and 64.70% for TRUS.
• It was noted that kappa coefficient was 0.42 and 0.39 respectively.
• In addition, the Delphi method indicated lower clinical effect of GS discordances for TPSMB with 7.8% of patients having significant change, thus being potentially more suitable for other treatment modalities, compared to TRUS (13.7%).