TORNA ALL’ELENCO

Impact of operator expertise on transperineal free-hand mpMRI-fusion-targeted biopsies under local anaesthesia for prostate cancer diagnosis: a multicenter prospective learning curve in World journal of urology

2023
AOU Città della Salute di Torino

Tipo pubblicazione

Article in Press

Autori/Collaboratori (15)Vedi tutti...

Calleris G
Department of Urology, San Giovanni Battista Hospital, University of Turin, Città della Salute e della ScienzaC.so Bramante 88/90, Turin, Italy
Marquis A
Department of Urology, San Giovanni Battista Hospital, University of Turin, Città della Salute e della ScienzaC.so Bramante 88/90, Turin, Italy
Zhuang J
Department of Urology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing University, Nanjing, Jiangsu, China

et alii...

Abstract

PURPOSE: Transperineal mpMRI-targeted fusion prostate biopsies (TPFBx) are recommended for prostate cancer diagnosis, but little is known about their learning curve (LC), especially when performed under local anaesthesia (LA). We investigated how operators' and institutions' experience might affect biopsy results. METHODS: Baseline, procedure and pathology data of consecutive TPFBx under LA were prospectively collected at two academic Institutions, from Sep 2016 to May 2019. Main inclusion criterion was a positive MRI. Endpoints were biopsy duration, clinically significant prostate cancer detection rate on targeted cores (csCDR-T), complications, pain and urinary function. Data were analysed per-centre and per-operator (with ? 50 procedures), comparing groups of consecutive patient, and subsequently through regression and CUSUM analyses. Learning curves were plotted using an adjusted lowess smoothing function. RESULTS: We included 1014 patients, with 27.3% csCDR-T and a median duration was 15 min (IQR 12-18). A LC for biopsy duration was detected, with the steeper phase ending after around 50 procedures, in most operators. No reproducible evidence in favour of an impact of experience on csPCa detection was found at operator's level, whilst a possible gentle LC of limited clinical relevance emerged at Institutional level; complications, pain and IPSS variations were not related to operator experience. CONCLUSION: The implementation of TPFBx under LA was feasible, safe and efficient since early phases with a relatively short learning curve for procedure time.

PMID : 37823940

DOI : 10.1007/s00345-023-04642-2

Keywords

adult; article; cancer diagnosis; clinical significance; complication; controlled study; diagnosis; human; International Prostate Symptom Score; learning curve; local anesthesia; major clinical study; male; multicenter study; multiparametric magnetic resonance imaging; nuclear magnetic resonance imaging; pain; prospective study; prostate cancer;