RT Journal Article
SR Electronic
T1 Italian Prostate Biopsies Group: 2016 Updated Guidelines Insights
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 413
OP 424
VO 37
IS 2
A1 ANDREA FANDELLA
A1 VINCENZO SCATTONI
A1 ANDREA GALOSI
A1 PIETRO PEPE
A1 MICHELANGELO FIORENTINO
A1 CATERINA GAUDIANO
A1 MARCO GIAMPAOLI
A1 ROBERTA GUNELLI
A1 PASQUALE MARTINO
A1 VITTORINO MONTANARO
A1 RODOLFO MONTIRONI
A1 TIZIANA PIERANGELI
A1 ARMANDO STABILE
A1 ALESSANDRO BERTACCINI
YR 2017
UL http://ar.iiarjournals.org/content/37/2/413.abstract
AB Aim: To present a summary of the updated guidelines of the Italian Prostate Biopsies Group following the best recent evidence of the literature. Materials and Methods: A systematic review of the new data emerging from 2012-2015 was performed by a panel of 14 selected Italian experts in urology, pathology and radiology. The experts collected articles published in the English-language literature by performing a search using Medline, EMBASE and the Cochrane Library database. The articles were evaluated using a systematic weighting and grading of the level of the evidence according to the Grading of Recommendations Assessment, Development and Evaluation framework system. Results: An initial prostate biopsy is strongly recommended when i) prostate specific antigen (PSA) >10 ng/ml, ii) digital rectal examination is abnormal, iii) multiparametric magnetic resonance imaging (mpMRI) has a Prostate Imaging Reporting and Data System (PIRADS) ≥4, even if it is not recommended. The use of mpMRI is strongly recommended only in patients with previous negative biopsy. At least 12 cores should be taken in each patient plus targeted (fusion or cognitive) biopsies of suspicious area (at mpMRI or transrectal ultrasound). Saturation biopsies are optional in all settings. The optimal strategy for reducing infection complications is still a controversial topic and the instruments to reduce them are actually weak. The adoption of Gleason grade groups in adjunction to the Gleason score when reporting prostate biopsy results is advisable. Conclusion: These updated guidelines and recommendations are intended to assist physicians and patients in the decision-making regarding when and how to perform a prostatic biopsy.