Repeat Prostate Biopsy Strategies after Initial Negative Biopsy: Meta-Regression Comparing Cancer Detection of Transperineal, Transrectal Saturation and MRI Guided Biopsy
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{"title"=>"Repeat Prostate Biopsy Strategies after Initial Negative Biopsy: Meta-Regression Comparing Cancer Detection of Transperineal, Transrectal Saturation and MRI Guided Biopsy", "type"=>"journal", "authors"=>[{"first_name"=>"Adam W.", "last_name"=>"Nelson", "scopus_author_id"=>"55989193300"}, {"first_name"=>"Rebecca C.", "last_name"=>"Harvey", "scopus_author_id"=>"55537676800"}, {"first_name"=>"Richard A.", "last_name"=>"Parker", "scopus_author_id"=>"55574241852"}, {"first_name"=>"Christof", "last_name"=>"Kastner", "scopus_author_id"=>"7005186839"}, {"first_name"=>"Andrew", "last_name"=>"Doble", "scopus_author_id"=>"7006118995"}, {"first_name"=>"Vincent J.", "last_name"=>"Gnanapragasam", "scopus_author_id"=>"6603009067"}], "year"=>2013, "source"=>"PLoS ONE", "identifiers"=>{"scopus"=>"2-s2.0-84874523744", "sgr"=>"84874523744", "issn"=>"19326203", "doi"=>"10.1371/journal.pone.0057480", "pmid"=>"23460864", "isbn"=>"1932-6203", "pui"=>"368445678"}, "id"=>"8c979d5f-5148-3a3a-818e-19212df7593d", "abstract"=>"INTRODUCTION: There is no consensus on how to investigate men with negative transrectal ultrasound guided prostate biopsy (TRUS-B) but ongoing suspicion of cancer. Three strategies used are transperineal (TP-B), transrectal saturation (TS-B) and MRI-guided biopsy (MRI-B). We compared cancer yields of these strategies.\\n\\nMETHODS: Papers were identified by search of Pubmed, Embase and Ovid Medline. Included studies investigated biopsy diagnostic yield in men with at least one negative TRUS-B and ongoing suspicion of prostate cancer. Data including age, PSA, number of previous biopsy episodes, number of cores at re-biopsy, cancer yield, and Gleason score of detected cancers were extracted. Meta-regression analyses were used to analyse the data.\\n\\nRESULTS: Forty-six studies were included; 12 of TS-B, 14 of TP-B, and 20 of MRI-B, representing 4,657 patients. Mean patient age, PSA and number of previous biopsy episodes were similar between the strategies. The mean number of biopsy cores obtained by TP-B and TS-B were greater than MRI-B. Cancer detection rates were 30·0%, 36·8%, and 37·6% for TS-B, TP-B, and MRI-B respectively. Meta-regression analysis showed that MRI-B had significantly higher cancer detection than TS-B. There were no significant differences however between MRI-B and TP-B, or TP-B and TS-B. In a sensitivity analysis incorporating number of previous biopsy episodes (36 studies) the difference between MRI-B and TP-B was not maintained resulting in no significant difference in cancer detection between the groups. There were no significant differences in median Gleason scores detected comparing the three strategies.\\n\\nCONCLUSIONS: In the re-biopsy setting, it is unclear which strategy offers the highest cancer detection rate. MRI-B may potentially detect more prostate cancers than other modalities and can achieve this with fewer biopsy cores. However, well-designed prospective studies with standardised outcome measures are needed to accurately compare modalities and define an optimum re-biopsy approach.", "link"=>"http://www.mendeley.com/research/repeat-prostate-biopsy-strategies-after-initial-negative-biopsy-metaregression-comparing-cancer-dete", "reader_count"=>44, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>1, "Librarian"=>2, "Researcher"=>11, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>4, "Student > Postgraduate"=>3, "Other"=>8, "Student > Master"=>5, "Student > Bachelor"=>3, "Lecturer"=>2, "Professor"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>1, "Librarian"=>2, "Researcher"=>11, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>4, "Student > Postgraduate"=>3, "Other"=>8, "Student > Master"=>5, "Student > Bachelor"=>3, "Lecturer"=>2, "Professor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>4, "Engineering"=>3, "Mathematics"=>1, "Medicine and Dentistry"=>32, "Agricultural and Biological Sciences"=>1, "Business, Management and Accounting"=>1, "Computer Science"=>1, "Economics, Econometrics and Finance"=>1}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>3}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>32}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Computer Science"=>{"Computer Science"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Mathematics"=>{"Mathematics"=>1}, "Unspecified"=>{"Unspecified"=>4}}, "reader_count_by_country"=>{"Netherlands"=>1, "United States"=>2, "China"=>1}, "group_count"=>6}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/972642", "https://ndownloader.figshare.com/files/972643"], "description"=>"<div><p>Introduction</p><p>There is no consensus on how to investigate men with negative transrectal ultrasound guided prostate biopsy (TRUS-B) but ongoing suspicion of cancer. Three strategies used are transperineal (TP-B), transrectal saturation (TS-B) and MRI-guided biopsy (MRI-B). We compared cancer yields of these strategies.</p> <p>Methods</p><p>Papers were identified by search of Pubmed, Embase and Ovid Medline. Included studies investigated biopsy diagnostic yield in men with at least one negative TRUS-B and ongoing suspicion of prostate cancer. Data including age, PSA, number of previous biopsy episodes, number of cores at re-biopsy, cancer yield, and Gleason score of detected cancers were extracted. Meta-regression analyses were used to analyse the data.</p> <p>Results</p><p>Forty-six studies were included; 12 of TS-B, 14 of TP-B, and 20 of MRI-B, representing 4,657 patients. Mean patient age, PSA and number of previous biopsy episodes were similar between the strategies. The mean number of biopsy cores obtained by TP-B and TS-B were greater than MRI-B. Cancer detection rates were 30·0%, 36·8%, and 37·6% for TS-B, TP-B, and MRI-B respectively. Meta-regression analysis showed that MRI-B had significantly higher cancer detection than TS-B. There were no significant differences however between MRI-B and TP-B, or TP-B and TS-B. In a sensitivity analysis incorporating number of previous biopsy episodes (36 studies) the difference between MRI-B and TP-B was not maintained resulting in no significant difference in cancer detection between the groups. There were no significant differences in median Gleason scores detected comparing the three strategies.</p> <p>Conclusions</p><p>In the re-biopsy setting, it is unclear which strategy offers the highest cancer detection rate. MRI-B may potentially detect more prostate cancers than other modalities and can achieve this with fewer biopsy cores. However, well–designed prospective studies with standardised outcome measures are needed to accurately compare modalities and define an optimum re-biopsy approach.</p> </div>", "links"=>[], "tags"=>["prostate", "biopsy", "strategies", "meta-regression", "comparing", "cancer", "detection", "transrectal", "saturation", "mri", "guided", "biopsy"], "article_id"=>641260, "categories"=>["Information And Computing Sciences", "Medicine", "Cancer"], "users"=>["Adam W. Nelson", "Rebecca C. Harvey", "Richard A. Parker", "Christof Kastner", "Andrew Doble", "Vincent J. Gnanapragasam"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0057480.s001", "https://dx.doi.org/10.1371/journal.pone.0057480.s002"], "stats"=>{"downloads"=>9, "page_views"=>27, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Repeat_Prostate_Biopsy_Strategies_after_Initial_Negative_Biopsy_Meta_Regression_Comparing_Cancer_Detection_of_Transperineal_Transrectal_Saturation_and_MRI_Guided_Biopsy__/641260", "title"=>"Repeat Prostate Biopsy Strategies after Initial Negative Biopsy: Meta-Regression Comparing Cancer Detection of Transperineal, Transrectal Saturation and MRI Guided Biopsy", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2013-02-28 11:25:23"}
  • {"files"=>["https://ndownloader.figshare.com/files/972637"], "description"=>"<p>The points represent different studies. Studies are distributed evenly either side of the zero line suggesting no clear evidence of publication bias.</p>", "links"=>[], "tags"=>["variability", "cancer", "detection", "residuals", "meta-regression"], "article_id"=>641255, "categories"=>["Information And Computing Sciences", "Medicine", "Cancer"], "users"=>["Adam W. Nelson", "Rebecca C. Harvey", "Richard A. Parker", "Christof Kastner", "Andrew Doble", "Vincent J. Gnanapragasam"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0057480.g001", "stats"=>{"downloads"=>1, "page_views"=>13, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Funnel_plot_showing_a_measure_of_variability_the_standard_error_of_the_cancer_detection_rate_against_the_residuals_from_the_meta_regression_model_with_results_shown_in_Table_3_main_results_table_/641255", "title"=>"Funnel plot showing a measure of variability (the standard error) of the cancer detection rate against the residuals from the meta-regression model with results shown in Table 3 (main results table).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-02-28 11:24:13"}
  • {"files"=>["https://ndownloader.figshare.com/files/972638"], "description"=>"<p>Literature search results (TP-B- Transperineal biopsy, TS-B-Transrectal saturation biopsy, MRI-B – MRI guided biopsy).</p>", "links"=>[], "tags"=>["transperineal", "ts-b-transrectal", "saturation", "mri-b", "mri", "guided"], "article_id"=>641256, "categories"=>["Information And Computing Sciences", "Medicine", "Cancer"], "users"=>["Adam W. Nelson", "Rebecca C. Harvey", "Richard A. Parker", "Christof Kastner", "Andrew Doble", "Vincent J. Gnanapragasam"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0057480.g002", "stats"=>{"downloads"=>5, "page_views"=>55, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Literature_search_results_TP_B_Transperineal_biopsy_TS_B_Transrectal_saturation_biopsy_MRI_B_8211_MRI_guided_biopsy_/641256", "title"=>"Literature search results (TP-B- Transperineal biopsy, TS-B-Transrectal saturation biopsy, MRI-B – MRI guided biopsy).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-02-28 11:24:47"}
  • {"files"=>["https://ndownloader.figshare.com/files/1005616"], "description"=>"‡<p>For the studies that do not report the mean number of biopsies, the median was used instead where possible. (TP-B – Transperineal biopsy, TS – B, Transrectal saturation biopsy, MRI-B – MRI guided biopsy).</p>", "links"=>[], "tags"=>["extracted", "biopsy"], "article_id"=>666242, "categories"=>["Information And Computing Sciences", "Medicine", "Cancer"], "users"=>["Adam W. Nelson", "Rebecca C. Harvey", "Richard A. Parker", "Christof Kastner", "Andrew Doble", "Vincent J. Gnanapragasam"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0057480.t002", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Weighted_summary_statistics_of_data_extracted_from_each_paper_by_repeat_biopsy_strategy_/666242", "title"=>"Weighted summary statistics of data extracted from each paper by repeat biopsy strategy.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-27 01:44:02"}
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  • {"files"=>["https://ndownloader.figshare.com/files/972641"], "description"=>"<p>The size of the bubble corresponds to the number of patients included (chart guide on the right of the figure). TP-B- Transperineal biopsy, TS-B-Transrectal saturation biopsy, MRI-B – MRI guided biopsy.</p>", "links"=>[], "tags"=>["cancer", "detection", "rates", "respective"], "article_id"=>641259, "categories"=>["Information And Computing Sciences", "Medicine", "Cancer"], "users"=>["Adam W. Nelson", "Rebecca C. Harvey", "Richard A. Parker", "Christof Kastner", "Andrew Doble", "Vincent J. Gnanapragasam"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0057480.g003", "stats"=>{"downloads"=>1, "page_views"=>23, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Bubble_plot_showing_the_cancer_detection_rates_and_respective_size_of_each_study_in_the_three_strategies_/641259", "title"=>"Bubble plot showing the cancer detection rates and respective size of each study in the three strategies.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-02-28 11:25:03"}
  • {"files"=>["https://ndownloader.figshare.com/files/1005580"], "description"=>"<p>TS-B is shown as the reference category for the purpose of comparison with the other two strategies. (TP-B – Transperineal biopsy, TS-B –Transrectal saturation biopsy, MRI-B – MRI guided biopsy).</p>", "links"=>[], "tags"=>["cancer", "detection", "adjusting"], "article_id"=>666200, "categories"=>["Information And Computing Sciences", "Medicine", "Cancer"], "users"=>["Adam W. Nelson", "Rebecca C. Harvey", "Richard A. Parker", "Christof Kastner", "Andrew Doble", "Vincent J. Gnanapragasam"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0057480.t004", "stats"=>{"downloads"=>1, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_regression_analysis_with_cancer_detection_rate_of_each_strategy_as_the_primary_outcome_adjusting_for_mean_age_mean_PSA_and_mean_number_of_previous_biopsies_/666200", "title"=>"Meta-regression analysis with cancer detection rate of each strategy as the primary outcome, adjusting for mean age, mean PSA, and mean number of previous biopsies.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-27 01:43:20"}
  • {"files"=>["https://ndownloader.figshare.com/files/1005633"], "description"=>"<p>TS-B is shown as the reference category for the purpose of comparison with the other two strategies. (TP-B – Transperineal biopsy, TS-B – Transrectal saturation biopsy, MRI-B – MRI guided biopsy).</p>", "links"=>[], "tags"=>["cancer", "detection"], "article_id"=>666258, "categories"=>["Information And Computing Sciences", "Medicine", "Cancer"], "users"=>["Adam W. Nelson", "Rebecca C. Harvey", "Richard A. Parker", "Christof Kastner", "Andrew Doble", "Vincent J. Gnanapragasam"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0057480.t003", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_regression_analysis_with_cancer_detection_rate_of_each_strategy_as_the_primary_outcome_/666258", "title"=>"Meta-regression analysis with cancer detection rate of each strategy as the primary outcome.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-02-27 01:44:18"}

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Relative Metric

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