Original article
Use of individual containers for prostate biopsy samples: Do we gain diagnostic performance?
Uso de contenedores individuales para las muestras obtenidas en biopsia prostática: ¿ganamos en rendimiento diagnóstico?
J. Panach-Navarrete
, F. García-Morata, L. Valls-González, J.M. Martínez-Jabaloyas
Corresponding author
Servicio de Urología, Hospital Clínico Universitario de Valencia, Valencia, Spain
Read
7
Timeswas read the article
4
Total PDF
3
Total HTML
Share statistics
array:24 [ "pii" => "S2173578616300051" "issn" => "21735786" "doi" => "10.1016/j.acuroe.2016.02.015" "estado" => "S300" "fechaPublicacion" => "2016-05-01" "aid" => "813" "copyright" => "AEU" "copyrightAnyo" => "2015" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2016;40:224-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 4 "formatos" => array:2 [ "HTML" => 1 "PDF" => 3 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0210480615002557" "issn" => "02104806" "doi" => "10.1016/j.acuro.2015.10.006" "estado" => "S300" "fechaPublicacion" => "2016-05-01" "aid" => "813" "copyright" => "AEU" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2016;40:224-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 87 "formatos" => array:2 [ "HTML" => 62 "PDF" => 25 ] ] "es" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artículo original</span>" "titulo" => "Uso de contenedores individuales para las muestras obtenidas en biopsia prostática: ¿ganamos en rendimiento diagnóstico?" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "224" "paginaFinal" => "228" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Use of individual containers for prostate biopsy samples: Do we gain diagnostic performance?" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. Panach-Navarrete, F. García-Morata, L. Valls-González, J.M. Martínez-Jabaloyas" "autores" => array:4 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Panach-Navarrete" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "García-Morata" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Valls-González" ] 3 => array:2 [ "nombre" => "J.M." "apellidos" => "Martínez-Jabaloyas" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173578616300051" "doi" => "10.1016/j.acuroe.2016.02.015" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578616300051?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480615002557?idApp=UINPBA00004N" "url" => "/02104806/0000004000000004/v1_201604260021/S0210480615002557/v1_201604260021/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173578616300063" "issn" => "21735786" "doi" => "10.1016/j.acuroe.2016.02.016" "estado" => "S300" "fechaPublicacion" => "2016-05-01" "aid" => "816" "copyright" => "AEU" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2016;40:229-36" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 7 "formatos" => array:2 [ "HTML" => 5 "PDF" => 2 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Current practice in Latin America of flexible ureterorenoscopy with laser for treating kidney stones" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "229" "paginaFinal" => "236" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Práctica actual de la ureteronefroscopia flexible con láser en América Latina para el tratamiento de la litiasis renal" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1947 "Ancho" => 2516 "Tamanyo" => 116460 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Preferred method for assessment of the free status of calculi in Latin America.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "B.O. Manzo, M. Bertacchi, E. Lozada, A. Rasguido, E. Aleman, M. Cabrera, A. Rodríguez, G. Manzo, H. Sánchez, J. Blasco" "autores" => array:10 [ 0 => array:2 [ "nombre" => "B.O." "apellidos" => "Manzo" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Bertacchi" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Lozada" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Rasguido" ] 4 => array:2 [ "nombre" => "E." "apellidos" => "Aleman" ] 5 => array:2 [ "nombre" => "M." "apellidos" => "Cabrera" ] 6 => array:2 [ "nombre" => "A." "apellidos" => "Rodríguez" ] 7 => array:2 [ "nombre" => "G." "apellidos" => "Manzo" ] 8 => array:2 [ "nombre" => "H." "apellidos" => "Sánchez" ] 9 => array:2 [ "nombre" => "J." "apellidos" => "Blasco" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210480615002582" "doi" => "10.1016/j.acuro.2015.11.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480615002582?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578616300063?idApp=UINPBA00004N" "url" => "/21735786/0000004000000004/v1_201604260030/S2173578616300063/v1_201604260030/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S217357861630004X" "issn" => "21735786" "doi" => "10.1016/j.acuroe.2016.02.014" "estado" => "S300" "fechaPublicacion" => "2016-05-01" "aid" => "811" "copyright" => "AEU" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2016;40:217-23" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 4 "formatos" => array:2 [ "HTML" => 2 "PDF" => 2 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Robot-assisted partial nephrectomy in 95 consecutive patients: Oncological and functional outcomes at 3 years of follow-up" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "217" "paginaFinal" => "223" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Nefrectomía parcial robótica en 95 pacientes consecutivos: resultados oncológicos y funcionales a 3 años de seguimiento" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1669 "Ancho" => 1651 "Tamanyo" => 101023 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Survival free of recurrence of the disease was 92.3% CI (56.7–98.8) at 48 months of follow-up according to the Kaplan–Meier method. CI (confidence interval) is highlighted in orange.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "O.A. Castillo, A. Rodríguez-Carlin, V. Borgna" "autores" => array:3 [ 0 => array:2 [ "nombre" => "O.A." "apellidos" => "Castillo" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Rodríguez-Carlin" ] 2 => array:2 [ "nombre" => "V." "apellidos" => "Borgna" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210480615002533" "doi" => "10.1016/j.acuro.2015.10.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480615002533?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357861630004X?idApp=UINPBA00004N" "url" => "/21735786/0000004000000004/v1_201604260030/S217357861630004X/v1_201604260030/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Use of individual containers for prostate biopsy samples: Do we gain diagnostic performance?" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "224" "paginaFinal" => "228" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. Panach-Navarrete, F. García-Morata, L. Valls-González, J.M. Martínez-Jabaloyas" "autores" => array:4 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "Panach-Navarrete" "email" => array:1 [ 0 => "jorpanav22@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "F." "apellidos" => "García-Morata" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Valls-González" ] 3 => array:2 [ "nombre" => "J.M." "apellidos" => "Martínez-Jabaloyas" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Urología, Hospital Clínico Universitario de Valencia, Valencia, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Uso de contenedores individuales para las muestras obtenidas en biopsia prostática: ¿ganamos en rendimiento diagnóstico?" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Transrectal prostate biopsy is a common intervention in the daily practice of urologists. Many aspects have been studied to optimize the diagnostic performance of prostate cancer by means of this procedure, such as the appropriate number of cylinders to be obtained, the location thereof, or the biopsy criteria for seminal vesicles.<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">1,2</span></a> However, there is a little collected aspect in the literature, but very important in the optimal biopsy result: the joint or individualized processing of prostate cylinders for histological examination.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The processing of the samples after the biopsy may have an impact on the diagnosis, and therefore on the subsequent therapeutic decision and prognosis of the patient. The urologist should play an active role for this diagnostic method to be as accurate as possible, always indicating clinical information to the pathologist (including PSA levels and biopsy purposes), obtaining properly from the cylinders, and carrying out an appropriate previous management and subsequent to the biopsy.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">This particular fact about the use of individual containers for subsequent histological examination is contained in the clinical guidelines of the European Association of Urology, stating that the samples are usually sent in separate vials for further study.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">4</span></a> However, a strict criterion to be followed is not expressed or a benefit demonstrated in reference to a higher diagnostic is completed.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Although there are other studies comparing the influence of the use of joint or individualized vials in prostate biopsy vials for different aspects, such as the detection of extracapsular involvement with transrectal biopsy, there is no weighty work aimed at concluding whether the different use of containers influences higher diagnosis.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">5</span></a> Thus, based on a large sample of patients biopsied at our center, we set as our primary objective to evidence if there is a difference in the diagnostic performance of prostate biopsy when making an individualized processing of the cylinders, using a container per sample; or processing the cylinders 2 single containers, corresponding to right and left prostatic lobes. As a secondary objective, we wanted to check whether there are differences in the diagnosis of different subgroups of tumors, by means of the different processing of the biopsy specimens.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">Retrospective observational study of 2601 cases of transrectal prostate biopsies performed at our center over 6 years. Patients continued throughout the period the protocol of prostate biopsy established in our department: antibiotic prophylaxis with ciprofloxacin 500<span class="elsevierStyleHsp" style=""></span>mg, one every 12<span class="elsevierStyleHsp" style=""></span>h for 5 days, starting the night before the test; administration of a cleansing enema the morning of the test; biopsy with 18<span class="elsevierStyleHsp" style=""></span>G diameter needle, and length of 25<span class="elsevierStyleHsp" style=""></span>cm; anesthesia prior to sampling with 10<span class="elsevierStyleHsp" style=""></span>ml of 2% lidocaine; discontinuation of antiplatelet therapy one week before the test, or substitution with low molecular weight heparin in case of treatment with anticoagulants. The processing of samples in the laboratory was the same in all cases: formalin fixation, dehydration of alcohols, xylols clearance, and paraffin embedding.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In all cases, 10 cylinders were obtained per biopsy. For the study, we divided the sample into 2 groups: shipping biopsy cylinders to the pathology department in 2 vials (corresponding to left lobe and right lobe), or shipping in 10 vials (one per cylinder), according to different criterion used in our center at different times. In each container was specified area of the prostate where the sample came from. Once in the laboratory, the samples sent in 2 containers were included in 2 blocks, and those shipped in 10 containers were included in a block each. All the biopsies were performed by the same urologist, and the histological study was carried out by a single pathologist subspecialized in genitourinary pathology.</p><p id="par0035" class="elsevierStylePara elsevierViewall">For the study, the homogeneity between the 2 working groups was checked in terms of PSA levels, age, prostate volume (by means of a Student's <span class="elsevierStyleItalic">t</span>-test), and suspicious DRE (using a chi-square test). Subsequently, and in order to obtain the primary and secondary objectives of the study, the cases were classified into different groups: absence of neoplasia; negligible adenocarcinoma (ADC) (involvement of a single cylinder, <5% involvement, Gleason <7); Gleason 6; or Gleason ≥7. In the bivariate statistical analysis, a chi-square test was used, and statistically significant differences were accepted with <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0040" class="elsevierStylePara elsevierViewall">A total of 1777 cases were included in the group of 2 containers and 824 cases in the group of 10. The groups were found to be homogeneous for the studied variables (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">As for the percentage of cancer diagnosis in each of the groups, 32.4% of diagnosis was observed in the group of 2 containers vs. 40% in the group of 10 containers, with a statistically significant difference (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001).</p><p id="par0050" class="elsevierStylePara elsevierViewall">As for the diagnosis in each subgroup, the results can be seen in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>. It was observed that, when using separate containers, there is a lower diagnosis of negligible ADC to the detriment of greater diagnosis of ADC Gleason 6. In the cases of Gleason ≥7, the same thing happens when comparing the diagnosis of any cancer to the absence of disease, the rate of diagnosis in this case is greater when using separate vials.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0055" class="elsevierStylePara elsevierViewall">The current analysis focuses on an aspect little studied so far in the process of prostate biopsy as it is individualized processing or set of tissue samples for subsequent anatomopathological examination. Currently there are no studies that conclude in favor of one option or another to obtain greater diagnostic performance of cancer. An example of this lack of criteria is shown in a European survey conducted in 2013, where only 40.8% of pathology laboratories admitted receiving the samples in separate vials.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">6</span></a> This lack of consensus, with the large sample we used for our analysis (2601 cases of biopsy), make the conclusions of this study useful and they can be used for future prospective randomized studies.</p><p id="par0060" class="elsevierStylePara elsevierViewall">Different facts in the process of biopsy have been influential for greater diagnostic performance. Bjurlin et al. claim that for optimal benefit 12 cylinders of tissue must be obtained, including samples of the apical and peripheral zone. This increases the detection rate, reduces the need for repeating the biopsy, and predicts the pathological features of the prostatectomy specimen. However, in the particular aspect of processing in vials, it is only concluded that no more than 2 cylinders should be sent per container in order not to lose the cancer detection rate.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">7</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Some authors argue that most information obtained by sending the samples independently is because, if the shipment is carried out in one or two containers, the samples tend to become entangled and are difficult to integrate all of them in a single plane for study in the microscope. This might lead to a difficult diagnosis, for example, in the case of small foci of atypical glands.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">8</span></a> Moreover, it has been observed that the fact of gathering numerous cylinders in the same container is a predisposing factor to fragmentation of the samples, which makes subsequent histological processing difficult. In a study where an average of 21.54<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.56 cylinders were sent in the same container, the pathologist quantified an average of 24.08<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.77, reflecting the problem of fragmentation.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">9</span></a> It has been found that the length of the cylinders affects the detection of cancerous lesions in the prostate, since longer cylinders provide more information. The length of the samples is considered by some as a guarantee of quality in the prostate biopsy.<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">10,11</span></a> The greatest length and integrity of the cylinders in the individual vials may be one of the hypotheses to explain the higher percentage of carcinomas diagnosed in the group of 10 containers observed in our work. As mentioned, upon arrival at the pathology laboratory, the cylinders were included in 2 blocks (one per lobe) or in 10 individual blocks in their processing for histological study. This aspect has been shown to be important for a better diagnostic performance.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">12</span></a> That is, not only the fact of sending the samples in separate containers influences the percentage of diagnosis, but the later inclusion into separate blocks could be another factor to be considered.</p><p id="par0070" class="elsevierStylePara elsevierViewall">Gupta et al., in a study with more than 1400 samples, concluded that sending the cylinders in individual containers, the misdiagnosis rate decreases. Furthermore, in the same work it was observed that by using between 6 and 12 vials, fewer atypical glands suspicious of ADC were diagnosed and fewer high-grade intraepithelial neoplasias.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">8</span></a> In our study, with the use of individual containers, we observed a lower diagnosis of insignificant ADC to the detriment of increased diagnosis of Gleason 6 carcinomas.</p><p id="par0075" class="elsevierStylePara elsevierViewall">However, not all authors defend the usefulness of individualizing the cylinders, concluding that the information provided by separating the samples does not compensate for the increase in associated costs. The simple distinction between samples of the right lobe and the left might be enough to, for example, reduce the risk of positive margins in the posterior surgery.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">5</span></a> Following in the line of studies that cast doubt on the usefulness of individualization, in 2008 a work was published stating that in the old sextant biopsy, information was lost by processing all the samples in a single container, but if used more than one container was used per lobe, this loss was avoided.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">13</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">Another aspect to consider in the context of prostate biopsy is the result dependent on the pathologist. Plourde et al. published in 2013 that the non-specialist pathologists in genitourinary disease request more immunohistochemical stainings than those used to treating this condition.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">14</span></a> This fact may reflect that the more or less frequent practice in relation to this disease can make people act differently, and therefore the results are different. In our work, all samples were analyzed by the same specialist pathologist. This gives consistency to the study results, but these cannot be extrapolated to other hypothetical scenarios where several pathologists had participated, or pathologists not specialized in genitourinary disease. Some authors have observed that even the fact that the laboratory technician in charge of cutting the samples possesses more or less experience could influence a higher quality thereof, and therefore a difference in diagnosis.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">12</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">Therefore, the optimal processing of the cylinders is at the level of other aspects on the prostate biopsy without strict performance criteria, such as the suitable number of samples and the specific cases where the seminal vesicles should be biopsied.<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">1,2,15</span></a> So, we think that in the future it would be necessary to reach a consensus on whether or not it is convenient to use individualized vials in the processing of the samples after the prostate biopsy. This fact is necessary to gain quality in this examination, in order to compare results between working groups, and to optimize decision-making by urologists.<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">16,17</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">The current paper presents some limitations. The first is that it is a retrospective study, with all the biases that this type of analysis carry. In addition, the fact that it was conducted in a single center raises the possibility of changes in the results if the study was expanded to multiple hospitals. The last of the limitations is that the processing in 2 or in 10 vials was made at different times, according to the protocol of our center at every moment, when the ideal thing would have been to alternate the 2 types of processing simultaneously.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusions</span><p id="par0095" class="elsevierStylePara elsevierViewall">More prostate cancers are diagnosed by sending the biopsied cylinders in individual containers. In addition, carrying out this maneuver, we have observed in our series a decrease in the diagnoses of insignificant carcinoma to the detriment of a greater diagnosis of non-insignificant carcinomas.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflict of interest</span><p id="par0100" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres631164" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec644017" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres631165" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec644018" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Material and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflict of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-09-10" "fechaAceptado" => "2015-10-09" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec644017" "palabras" => array:4 [ 0 => "Prostate cancer" 1 => "Biopsy" 2 => "Diagnosis" 3 => "Gleason" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec644018" "palabras" => array:4 [ 0 => "Cáncer de próstata" 1 => "Biopsia" 2 => "Diagnóstico" 3 => "Gleason" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Prostate cores from transrectal biopsies are usually sent in separate vials for pathological processing. Although this is a common practice, there are controversial studies on its usefulness.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We wanted to compare the rate of prostate cancer diagnosis between processing samples in 2 containers and processing them in individual containers to see if there are differences. Our secondary objective was to check the rate of diagnosis of various tumor subtypes in each of the 2 groups.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A retrospective observational study was conducted of 2601 cases of prostate biopsies. Ten cores were extracted in each biopsy. We divided the sample into 2 groups: biopsies sent in 2 containers to the department of pathology (left and right lobes) or sent in 10 (one for each cylinder), according to the different criteria used in our center in the past.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">We then classified the cases according to the absence of neoplasia, insignificant tumor (involvement of just 1 cylinder, <5%, Gleason score <7), Gleason 6 or Gleason ≥7. A bivariate statistical analysis was performed using the chi-squared test.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A total of 1777 participants were included in the 2-container group, and 824 were included in the 10-container group. We diagnosed a rate of 32.4% of cancers in the 2-container group and 40% in the 10-container group, a difference that was statistically significant (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001).</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The insignificant carcinomas were diagnosed more often in the 2-container group than in the 10-container group (6.4% vs. 4.3%, respectively; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.03). Samples with a Gleason score of 6 were diagnosed more often in the 10-container group than in the 2-container group (11.9% vs. 8.1%, respectively; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.002). The same occurred with the Gleason score ≥7 (23.8% in the 10-container group vs. 17.9% in the 2-container group; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001).</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We diagnosed more prostate cancers when sending biopsied cores in individual containers. Once the procedure was conducted, we also observed in our series a reduction in the diagnoses of insignificant carcinoma to the detriment of an increased diagnosis of not insignificant carcinomas.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los cilindros de próstata obtenidos en la biopsia transrectal suelen enviarse en viales separados para su procesamiento anatomopatológico. Aunque es una práctica frecuente, existen trabajos controvertidos sobre su utilidad.</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Se quiso comparar el porcentaje de diagnóstico de cáncer de próstata al procesar las muestras en 2 contenedores o en contenedores individuales, para comprobar si existen diferencias. Como objetivo secundario se han comprobado los porcentajes de diagnóstico de varios subtipos de tumores en cada uno de los 2 grupos.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y métodos</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo observacional sobre 2.601 casos de biopsias prostáticas. Se extrajeron 10 cilindros en cada biopsia. Dividimos la muestra en 2 grupos: envío de biopsia al servicio de anatomía patológica en 2 recipientes (lóbulo izquierdo y derecho) o en 10 (uno por cada cilindro), según diferente criterio utilizado en nuestro centro en varias épocas.</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Posteriormente se clasificaron los casos según ausencia de neoplasia, tumor insignificante (afectación de un solo cilindro, <<span class="elsevierStyleHsp" style=""></span>5%, Gleason<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>7), Gleason 6, Gleason<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>7. Análisis estadístico bivariante mediante Chi-cuadrado.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 1.777 sujetos en el grupo de 2 contenedores y 824 en el de 10. Se diagnosticaron un 32,4% de cánceres en el grupo de 2 recipientes y un 40% en el de 10, existiendo una diferencia estadísticamente significativa (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,001).</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Los carcinomas insignificantes se diagnosticaban con más frecuencia en el grupo de 2 botes, el 6,4% frente al 4,3% en el de 10 (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,03). Los Gleason 6 se diagnosticaban más en el grupo de 10 contenedores en comparación con el de 2 (11,9% frente al 8,1% [p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,002]). Lo mismo sucedía con los Gleason<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>7, el 23,8% en el grupo de 10 viales frente al 17,9% en el de 2 (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,001).</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Se diagnostican más cánceres de próstata al enviar los cilindros biopsiados en botes individuales. Además, llevando a cabo esta maniobra, hemos observado en nuestra serie una disminución de los diagnósticos de carcinoma insignificante en detrimento de un mayor diagnóstico de carcinomas no insignificantes.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Panach-Navarrete J, García-Morata F, Valls-González L, Martínez-Jabaloyas JM. Uso de contenedores individuales para las muestras obtenidas en biopsia prostática: ¿ganamos en rendimiento diagnóstico? Actas Urol Esp. 2016;40:224–228.</p>" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">PSA: specific prostate antigen.</p><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Statistical analysis by means of Student's <span class="elsevierStyleItalic">t</span>-test and chi-square test.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Two containers \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Ten containers \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sig. \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PSA (ng/ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19.93 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.889 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Prostate volume (cc) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">82.73 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54.06 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.443 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age (years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">66.39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">65.96 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.194 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DRE (% of suspects) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.11 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1035452.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Baseline characteristics of the sample.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">ADC: adenocarcinoma.</p><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Statistical analysis by means of chi-square test.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Subgroup \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Two containers (diagnosis in %) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Ten containers (diagnosis in %) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sig. \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Insignificant ADC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.03 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gleason 6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.002 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gleason ≥7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1035453.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Difference of percentages for the diagnosis of each subgroup of cancer, on the total of the sample in each of the groups (2 and 10 containers).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:17 [ 0 => array:3 [ "identificador" => "bib0090" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnostic value of systematic biopsy methods in the investigation of prostate cancer: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "K. Eichler" 1 => "S. Hempel" 2 => "J. Wilby" 3 => "L. Myers" 4 => "L.M. Bachmann" 5 => "J. Kleijnen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0022-5347(05)00957-2" "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "2006" "volumen" => "175" "paginaInicial" => "1605" "paginaFinal" => "1612" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16600713" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0095" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "When to biopsy seminal vesicles" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Panach-Navarrete" 1 => "F. Garcia-Morata" 2 => "J.A. Hernandez-Medina" 3 => "J.M. Martinez-Jabaloyas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.acuro.2014.10.006" "Revista" => array:6 [ "tituloSerie" => "Actas Urol Esp" "fecha" => "2015" "volumen" => "39" "paginaInicial" => "203" "paginaFinal" => "209" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25466644" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0100" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Handling and pathology reporting of prostate biopsies" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "European Society of Uropathology Working Group" "etal" => false "autores" => array:5 [ 0 => "L. Boccon-Gibod" 1 => "T.H. van der Kwast" 2 => "R. Montironi" 3 => "L. Boccon-Gibod" 4 => "A. Bono" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eururo.2004.04.006" "Revista" => array:6 [ "tituloSerie" => "Eur Urol" "fecha" => "2004" "volumen" => "46" "paginaInicial" => "177" "paginaFinal" => "181" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15245810" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0105" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent-update 2013" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Heidenreich" 1 => "P.J. Bastian" 2 => "J. Bellmunt" 3 => "M. Bolla" 4 => "S. Joniau" 5 => "T. van der Kwast" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eururo.2013.09.046" "Revista" => array:6 [ "tituloSerie" => "Eur Urol" "fecha" => "2014" "volumen" => "65" "paginaInicial" => "124" "paginaFinal" => "137" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24207135" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0110" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Does site specific labeling of sextant biopsy cores predict the site of extracapsular extension in radical prostatectomy surgical specimen" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.S. Taneja" 1 => "D.F. Penson" 2 => "A. Epelbaum" 3 => "T. Handler" 4 => "H. Lepor" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "1999" "volumen" => "162" "paginaInicial" => "1352" "paginaFinal" => "1357" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10492195" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0115" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prostate needle biopsy processing: a survey of laboratory practice across Europe" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Varma" 1 => "D.M. Berney" 2 => "F. Algaba" 3 => "P. Camparo" 4 => "E. Comperat" 5 => "D.F. Griffiths" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/jclinpath-2012-200993" "Revista" => array:6 [ "tituloSerie" => "J Clin Pathol" "fecha" => "2013" "volumen" => "66" "paginaInicial" => "120" "paginaFinal" => "123" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23112115" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0120" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Optimization of initial prostate biopsy in clinical practice: sampling, labeling and specimen processing" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.A. Bjurlin" 1 => "H.B. Carter" 2 => "P. Schellhammer" 3 => "M.S. Cookson" 4 => "L.G. Gomella" 5 => "D. Troyer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.juro.2013.02.072" "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "2013" "volumen" => "189" "paginaInicial" => "2039" "paginaFinal" => "2046" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23485507" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0125" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Individual submission and embedding of prostate biopsies decreases rates of equivocal pathology reports" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Gupta" 1 => "J.Z. Ren" 2 => "K.J. Wojno" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Urology" "fecha" => "2004" "volumen" => "63" "paginaInicial" => "83" "paginaFinal" => "86" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14751354" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0130" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The impact of core biopsy fragmentation in prostate cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "L.O. Reis" 1 => "J.A. Reinato" 2 => "D.C. Silva" 3 => "W.E. Matheus" 4 => "F. Denardi" 5 => "U. Ferreira" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11255-010-9720-0" "Revista" => array:6 [ "tituloSerie" => "Int Urol Nephrol" "fecha" => "2010" "volumen" => "42" "paginaInicial" => "965" "paginaFinal" => "969" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20221804" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0135" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Needle core length in sextant biopsy influences prostate cancer detection rate" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K.A. Iczkowski" 1 => "G. Casella" 2 => "R.J. Seppala" 3 => "G.L. Jones" 4 => "B.A. Mishler" 5 => "J. Qian" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Urology" "fecha" => "2002" "volumen" => "59" "paginaInicial" => "698" "paginaFinal" => "703" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11992843" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0140" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnostic effect of an improved preembedding method of prostate needle biopsy specimens" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. Rogatsch" 1 => "P. Moser" 2 => "H. Volgger" 3 => "W. Horninger" 4 => "G. Bartsch" 5 => "G. Mikuz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/hupa.2000.9837" "Revista" => array:6 [ "tituloSerie" => "Hum Pathol" "fecha" => "2000" "volumen" => "31" "paginaInicial" => "1102" "paginaFinal" => "1107" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11014578" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0145" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The critical role of the pathologist in determining eligibility for active surveillance as a management option in patients with prostate cancer: consensus statement with recommendations supported by the College of American Pathologists, International Society of Urological Pathology, Association of Directors of Anatomic and Surgical Pathology, the New Zealand Society of Pathologists, and the Prostate Cancer Foundation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.B. Amin" 1 => "D.W. Lin" 2 => "J.L. Gore" 3 => "J.R. Srigley" 4 => "H. Samaratunga" 5 => "L. Egevad" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5858/arpa.2014-0219-SA" "Revista" => array:6 [ "tituloSerie" => "Arch Pathol Lab Med" "fecha" => "2014" "volumen" => "138" "paginaInicial" => "1387" "paginaFinal" => "1405" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25092589" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0150" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prostate biopsies: how many samples and how many containers? Cost effectiveness" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "V. Molinie" 1 => "W.K. Mahjoub" 2 => "A. Balaton" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.annpat.2008.05.005" "Revista" => array:6 [ "tituloSerie" => "Ann Pathol" "fecha" => "2008" "volumen" => "28" "paginaInicial" => "424" "paginaFinal" => "428" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19068397" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0155" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Patterns in immunohistochemical usage in extended core prostate biopsies: comparisons among genitourinary pathologists and nongenitourinary pathologists" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Plourde" 1 => "A. Gross" 2 => "Z. Jiang" 3 => "C.L. Owens" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5858/arpa.2012-0517-OA" "Revista" => array:6 [ "tituloSerie" => "Arch Pathol Lab Med" "fecha" => "2013" "volumen" => "137" "paginaInicial" => "1630" "paginaFinal" => "1634" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24168501" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0160" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Indications for seminal vesicle biopsy and laparoscopic pelvic lymph node dissection in men with localized carcinoma of the prostate" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "N.N. Stone" 1 => "R.G. Stock" 2 => "P. Unger" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "1995" "volumen" => "154" "paginaInicial" => "1392" "paginaFinal" => "1396" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7658545" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0165" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidelines for processing and reporting of prostatic needle biopsies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T.H. Van der Kwast" 1 => "C. Lopes" 2 => "C. Santonja" 3 => "C.G. Pihl" 4 => "I. Neetens" 5 => "P. Martikainen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Clin Pathol" "fecha" => "2003" "volumen" => "56" "paginaInicial" => "336" "paginaFinal" => "340" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12719451" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0170" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Systematic development of clinical practice guidelines for prostate biopsies: a 3-year Italian project" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Bertaccini" 1 => "A. Fandella" 2 => "T. Prayer-Galetti" 3 => "V. Scattoni" 4 => "A.B. Galosi" 5 => "V. Ficarra" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Anticancer Res" "fecha" => "2007" "volumen" => "27" "paginaInicial" => "659" "paginaFinal" => "666" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17348457" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735786/0000004000000004/v1_201604260030/S2173578616300051/v1_201604260030/en/main.assets" "Apartado" => array:4 [ "identificador" => "6274" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735786/0000004000000004/v1_201604260030/S2173578616300051/v1_201604260030/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578616300051?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2023 March | 2 | 1 | 3 |
| 2016 June | 1 | 2 | 3 |
| 2016 April | 0 | 1 | 1 |
