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Master Thesis

Impact des biopsies ciblées dans le cadre de la surveillance active du cancer de prostate chez les patients caribéens

Abstract : BACKGROUND: Targeted biopsies (TB) by fusion between transrectal ultrasound and Multiparametric-magnetic resonance imaging (mp-MRI) have shown benefit in the detection of high-grade prostate cancer (PCa). However, the diagnostic performance in men under active surveillance (AS) remains unclear. This study observes the introduction of this technique in a Caribbean population under AS. We aimed to investigate the impact of TB by MRI-ultrasound fusion by observing its contribution in the care of our patients under AS. METHODS: In a monocentric, retrospective study, we identified among our patients in SA, those with lesion images on mp-MRI. We studied two groups: Standard Biopsies (SB) alone and SB + TB. We report the impact of TB on the selected population under AS, as well as the results of TB and SB in the subgroup that benefited from both techniques. RESULTS: A total of 238 men from our cohort of AS patients were included. Of these men, 69 benefited from TB. AS survival is the same in both groups. Observing the exit patterns, the only statistically significant criterion is the biopsy endpoint for Gleason ≥ 3 + 4, higher in the SB + TB group (42.22% in the BS group against 81.25% in the SB + TB group ; p = 0.0001). In the subgroup of patients who received SB + TB, 33 men (48%) had a significant cancer finding, a significant difference was reported in favour of single SB versus TB alone (29 (42%) vs. 22 (31%) ; p <0.05). No difference was found in the discovery of PCa with Gleason ≥ 7 (21 (30%) versus 19 (28%) ; p = 0.2). CONCLUSIONS: TB by MRI-ultrasound fusion did not show any impact on AS survival in our cohort. Nevertheless, its contribution to the detection of Gleason scores ≥ 7 is noted.
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Master Thesis
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Submitted on : Friday, January 31, 2020 - 2:55:46 PM
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Charles Laine. Impact des biopsies ciblées dans le cadre de la surveillance active du cancer de prostate chez les patients caribéens. Urologie et Néphrologie. 2019. ⟨dumas-02462736⟩



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