Detection of Clinically Significant Cancer in the Anterior Prostate by Transperineal Biopsy.

Abstract

The objective was to determine the incidence of clinically significant prostate cancer detected exclusively in the anterior prostate using transperineal prostate biopsy. Histopathology results of all patients who underwent transperineal prostate biopsy between February 2016 and March 2018 at a single institution were assessed for distribution of cancer within the prostate. Patients with cancer found exclusively in the anterior prostate were then compared to those with any cancer found in the posterior or lateral prostate with International Society of Urological Pathology (ISUP) grade group 2-5 cancers being considered clinically significant. 508 patients were included. Overall, 12.0% of the cohort had clinically significant cancer detected only in anterior biopsies. When stratified by PSA, 6.6% of men with PSA 4.1-10.0ng/ml and 8.2% of men with PSA >10.0ng/ml had clinically significant cancer detected in the anterior prostate alone. Transperineal biopsy has the ability to diagnose clinically significant anteriorly located prostate cancers that would potentially have been missed by the transrectal approach.