Role Of Anterior Prostate Sampling Using A Novel Philadelphia Hybrid Anatomic Transperineal (Phat) Template: A Single Center Experience

You have accessJournal of UrologyProstate Cancer: Detection & Screening II (MP26)1 Sep 2021MP26-02 ROLE OF ANTERIOR PROSTATE SAMPLING USING A NOVEL PHILADELPHIA HYBRID ANATOMIC TRANSPERINEAL (PHAT) TEMPLATE: A SINGLE CENTER EXPERIENCE Johnathan Drevik, Adams Ako, Jeffrey Ellis, Phillip Abbosh, Jay Simhan, Justin Friedlander, Steven Sterious, Joshua Cohn, Robert Uzzo, and Serge Ginzburg Johnathan DrevikJohnathan Drevik More articles by this author , Adams AkoAdams Ako More articles by this author , Jeffrey EllisJeffrey Ellis More articles by this author , Phillip AbboshPhillip Abbosh More articles by this author , Jay SimhanJay Simhan More articles by this author , Justin FriedlanderJustin Friedlander More articles by this author , Steven SteriousSteven Sterious More articles by this author , Joshua CohnJoshua Cohn More articles by this author , Robert UzzoRobert Uzzo More articles by this author , and Serge GinzburgSerge Ginzburg More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002023.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Transperineal prostate biopsy approach has become more widespread due to lower rate of post-biopsy infections and better anterior gland sampling. Despite its increasing adoption, no universal transperineal template exists and the role of routine anterior gland sampling remains undefined. Here we propose a simplified office-based transperineal biopsy template and describe cancer distribution and the relevance of anterior cores. METHODS: A retrospective chart review of patients that underwent PHAT template transperineal biopsy (Figure 1a) between November 2017 through November 2020 was performed and clinicopathologic data along with relevant multiparametric MRI (mpMRI) data were abstracted. In patients with multiple biopsies only the initial systematic biopsy was included. Clinically significant cancer (csCa) was defined as ≥ GG2. Descriptive statistics were utilized to evaluate cancer detection rate and location. RESULTS: 178 unique patients (median age 64.0, IQR 10, median PSA 9.2, IQR 4.7) comprised the cohort of interest. 148 (83%) were performed in the office under local analgesia. Overall, cancer detection rate (CDR) was 140/178 (79%), while csCa was present in 94/178 (52.8%) The distribution of detected cancer using the PHAT template can be seen in Figure 1b. Cancer in anterior cores only was observed in 21 (11.8%) men, with 57.1% being csCa. mpMRI was available for 13 of 21 (61.9%) patients with anterior-only prostate cancer, of which 8/13 (61.5%) had no anterior lesions detected on MRI. Morbidity of this remained remained low, without any episodes of sepsis. CONCLUSIONS: The PHAT prostate biopsy template provides a high CDR and allows for comprehensive anterior gland sampling with minimal morbidity. Importance of routine anterior gland sampling is underscored, as 2/3 of anterior-only cancers would be missed if mpMRI alone was used to triage anterior gland targeting. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e462-e462 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Johnathan Drevik More articles by this author Adams Ako More articles by this author Jeffrey Ellis More articles by this author Phillip Abbosh More articles by this author Jay Simhan More articles by this author Justin Friedlander More articles by this author Steven Sterious More articles by this author Joshua Cohn More articles by this author Robert Uzzo More articles by this author Serge Ginzburg More articles by this author Expand All Advertisement Loading ...