PURPOSE: For patients under active surveillance (AS), there was limited data about transition zone (TZ) sampling on follow-up biopsy.
Our study aimed at verifying the value of TZ biopsy in AS settings.
MATERIALS AND METHODS: In our study, we included 1059 sets of prostate biopsies from 534 patients under AS at the Johns Hopkins Hospital. Each set comprised at least 14 cores with 2 or more from TZ. Among these patients, 53 men underwent radical prostatectomy (RP).
RESULTS: Patients with tumors in both PZ and TZ had higher maximum Gleason score and increased maximum percentage of cancer per core compared to either PZ or TZ only group. In 12 patients (2.2% of 534), the tumor on AS biopsy was limited to the TZ core(s). Eleven patients (2.1% of 534) showed tumor with high Gleason score (>6) or extensive involvement (>50%) of any core exclusively on TZ biopsy. However, in 10 (66.7%) of 15 RP cases with prior positive TZ biopsies, the tumors had actually little or no TZ components. In addition, the TZ status on biopsy had no significant relationship with Gleason score, extraprostatic extension, or seminal vesicle involvement in RP.
CONCLUSIONS: Our data suggested that the additional yield is sufficiently low to argue against routine TZ sampling in men undergoing follow-up biopsy on AS, although further study is needed for definitive recommendations.
Written by:
Wang CC, Carter HB, Epstein JI. Are you the author?
The Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD.
Reference: J Urol. 2013 Dec 5. pii: S0022-5347(13)06016-3.
doi: 10.1016/j.juro.2013.11.058
PubMed Abstract
PMID: 24316092
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