Mp52-06 Immediate Radical Prostatectomy After Intraoperative Confirmed Diagnosis of Prostate Cancer by Frozen Section of Specimen From Targeted Biopsy-Investigation of a Novel Strategy

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy II (MP52)1 May 2024MP52-06 IMMEDIATE RADICAL PROSTATECTOMY AFTER INTRAOPERATIVE CONFIRMED DIAGNOSIS OF PROSTATE CANCER BY FROZEN SECTION OF SPECIMEN FROM TARGETED BIOPSY-INVESTIGATION OF A NOVEL STRATEGY Miao Wang, Xuan Wang, Longteng Liu, and Ming Liu Miao WangMiao Wang , Xuan WangXuan Wang , Longteng LiuLongteng Liu , and Ming LiuMing Liu View All Author Informationhttps://doi.org/10.1097/01.JU.0001008864.84854.b7.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We present the preliminary experience of a novel strategy combining the technique of frozen section and targeted biopsy guided by combined precision imaging (bp-MRI and PSMA PET/CT), based on which the pathway of radical prostatectomy (RP) and prostate biopsy could be further simplified, and the false positive diagnosis by imaging could be avoided, and investigated the feasibility and safety. METHODS: In this prospective phase II trial, all patients underwent bp-MRI and PSMA PET/CT and had at least one suspicious lesion. A transperineal targeted biopsy was conducted with 1-2 cores taken. The specimen taken was then sent for a fast histopathologic diagnosis by frozen section. An immediate RP during the same surgery would be conducted once the diagnosis of PCa was confirmed. Otherwise, a standard target plus systematic biospy would be further conducted if the frozen section revealed a negative result. RESULTS: A total of 16 patients were enrolled up to now. The median age was 68 (54-79) years. The median PSA level was 13.78 (4.36 -23.57) ng/mL. All patients had lesions positive on both imaging. 3 had PI-RADS 3 lesions, 8 had PI-RADS 4, and 5 had PI-RADS 5 lesions. The median diameter was 1.1 (0.4-2.2) cm on bp-MRI, with the median SUVmax of 14.6 (5.1-39.4) on PSMA PET/CT. All 16 patients underwent 2-core targeted biopsy and the frozen section all revealed PCa. 8 patients had ISUP grade group (GG) 3 disease, 3 had GG 2, 3 had GG 3 and 2 had GG 4 disease on biopsy. After immediate RP, all patients were confirmed to have PCa by whole mount section. The median operation time was 132.9 (104-255) min. The surgeon reported no intraoperative tissue adhesion. 3 patients had GG 1 disease, 8 had GG 2, 4 had GG 3 and 1 had GG 4 disease by final pathology. 8 patients had pT2 disease while 8 patients had pT3a disease. Positive surgical margin was found in 4 patients. The median PSA level was 0.01 (0.00-0.08) ng/mL 6 weeks postoperatively. No Clavien-Dindo I or more severe complications occurred. CONCLUSIONS: The novel strategy was initially proved to be safe and feasible. More data are needed to confirm the superiority over the conventional "Biopsy-RP" treatment pathway. Source of Funding: National High Level Hospital Clinical Research Funding (BJ-2022-115) © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e854 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Miao Wang More articles by this author Xuan Wang More articles by this author Longteng Liu More articles by this author Ming Liu More articles by this author Expand All Advertisement PDF downloadLoading ...