Beyond Diagnosis Evolving Prostate Biopsy in the Era of Focal Therapy英文文献资料.docVIP

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Beyond Diagnosis Evolving Prostate Biopsy in the Era of Focal Therapy英文文献资料.doc

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Beyond Diagnosis Evolving Prostate Biopsy in the Era of Focal Therapy英文文献资料

HindawiPublishingCorporation ProstateCancer Volume2011,ArticleID386207,11pages doi:10.1155/2011/386207 ReviewArticle BeyondDiagnosis:EvolvingProstateBiopsyin theEraofFocalTherapy J.L.Dominguez-Escrig,S.R.C.McCracken,andD.Greene UrologyDepartment,SunderlandRoyalHospital,KayllRoad,SunderlandSR47TP,UK CorrespondenceshouldbeaddressedtoD.Greene,damian.greene@chs.northy.nhs.uk Received2July2010;Accepted14October2010 AcademicEditor:AlexandreR.Zlotta Copyright?2011J.L.Dominguez-Escrigetal.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttribution License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly cited. Despite decades of use as the “gold standard” in the detection of prostate cancer, the optimal biopsy regimen is still not universallyagreed upon. Whileimportantaspects such astheneed forlaterallyplaced biopsiesandtheimportanceof apical cancerareknown,repeatedstudieshaveshownsigni?cantpatientswithcanceronsubsequentbiopsywhentheoriginalbiopsy was negative and an ongoing suspicion of cancer remained. Attempts to maximise the e?ectiveness of repeat biopsies have givenrise to thealternateapproaches ofsaturationbiopsyandthetransperineal approach. Recent interest infocaltreatment ofprostatecancerhasfurtherhighlightedtheneedforaccuratedetectionofprostatecancer,andinresponse,theintroduction oftransperinealtemplate-guidedbiopsy.Whilethesaturationbiopsyapproachandthetransperinealtemplateapproachincrease thedetection rate ofcancerin menwith aprevious negative biopsyandappear to haveacceptable morbidity, thereis alack of clinical trials evaluating the di?erent biopsy strategies. This paper reviews the evolution of prostatic biopsy and current controversies. 1.Introduction 2.LimitationsofSextantBiopsy Prostate cancer is now recognized as one of the major medical problems facing the male population. In Europe, withanannualincidenceof214casesper1000men,prostate cancerrepresentsthemostcommonsolidtumoura?ecting