array:23 [ "pii" => "S0210480608739731" "issn" => "02104806" "doi" => "10.1016/S0210-4806(08)73973-1" "estado" => "S300" "fechaPublicacion" => "2008-01-01" "aid" => "73973" "copyright" => "Asociación Española de Urología (AEU)" "copyrightAnyo" => "2008" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2008;32:961-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1141 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 714 "PDF" => 421 ] ] "itemSiguiente" => array:18 [ "pii" => "S0210480608739743" "issn" => "02104806" "doi" => "10.1016/S0210-4806(08)73974-3" "estado" => "S300" "fechaPublicacion" => "2008-01-01" "aid" => "73974" "copyright" => "Asociación Española de Urología (AEU)" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2008;32:968-75" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1287 "formatos" => array:3 [ "EPUB" => 8 "HTML" => 830 "PDF" => 449 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Prostatectomía radical: comparación de los resultados obtenidos durante las curvas de aprendizaje de la técnica laparoscópica pura y de la técnica asistida por robot con la prostatectomía radical retropúbica" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "968" "paginaFinal" => "975" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Radical prostatectomy: evaluation of learning curve outcomes laparoscopic and robotic-assisted laparoscopic techniques with radical retropubic prostatectomy" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.P. Caballero Romeu, J. Palacios Ramos, J.G. Pereira Arias, M. Gamarra Quintanilla, A. Astobieta Odriozola, G. Ibarluzea González" "autores" => array:6 [ 0 => array:2 [ "nombre" => "J.P." "apellidos" => "Caballero Romeu" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Palacios Ramos" ] 2 => array:2 [ "nombre" => "J.G." "apellidos" => "Pereira Arias" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Gamarra Quintanilla" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Astobieta Odriozola" ] 5 => array:2 [ "nombre" => "G." "apellidos" => "Ibarluzea González" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480608739743?idApp=UINPBA00004N" "url" => "/02104806/0000003200000010/v1_201304251917/S0210480608739743/v1_201304251917/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S021048060873972X" "issn" => "02104806" "doi" => "10.1016/S0210-4806(08)73972-X" "estado" => "S300" "fechaPublicacion" => "2008-01-01" "aid" => "73972" "copyright" => "Asociación Española de Urología (AEU)" "documento" => "article" "crossmark" => 0 "subdocumento" => "edi" "cita" => "Actas Urol Esp. 2008;32:957-60" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1380 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 871 "PDF" => 503 ] ] "es" => array:7 [ "idiomaDefecto" => true "titulo" => "Uso de antimuscarínicos en pacientes con STUI-HBP y síntomas de VHA: maestría clínica y resistencia a perder el miedo al riesgo de retención urinaria" "tienePdf" => "es" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "957" "paginaFinal" => "960" ] ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.L. Ruiz Cerdá" "autores" => array:1 [ 0 => array:2 [ "nombre" => "J.L." "apellidos" => "Ruiz Cerdá" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021048060873972X?idApp=UINPBA00004N" "url" => "/02104806/0000003200000010/v1_201304251917/S021048060873972X/v1_201304251917/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Características clínicas e histopatológicas del cáncer de próstata diagnosticado a partir de la tercera biopsia" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "961" "paginaFinal" => "967" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M.P. Bahílo Mateu, M. Ramírez Backhaus, M. Trassierra Villa, C. Di Capua Sacoto, S. Arlandis Guzmán, J.F. Jiménez Cruz" "autores" => array:6 [ 0 => array:4 [ "nombre" => "M.P." "apellidos" => "Bahílo Mateu" "email" => array:1 [ 0 => "pilarbahilo@comv.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Ramírez Backhaus" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Trassierra Villa" ] 3 => array:2 [ "nombre" => "C." "apellidos" => "Di Capua Sacoto" ] 4 => array:2 [ "nombre" => "S." "apellidos" => "Arlandis Guzmán" ] 5 => array:2 [ "nombre" => "J.F." "apellidos" => "Jiménez Cruz" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Urología. Hospital Universitario La Fe. Valencia" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia autor: Dra. M.P. Bahílo Mateu Servicio de Urología. Hospital Universitario La Fe Avda. Campanar, 21- 46009. Valencia. Tel.: 963 862 700" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Clinical features and histopathology of prostate cancer diagnosed from the third biopsy" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2008-04-01" "fechaAceptado" => "2008-07-01" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec88742" "palabras" => array:2 [ 0 => "Biopsia prostática de repetición" 1 => "Cáncer de próstata" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec88741" "palabras" => array:2 [ 0 => "Repeated prostate biopsy" 1 => "Prostate cancer" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Estudiar las características histopatológicas y clínicas de los tumores diagnosticados a partir de terceras biopsias para valorar la relevancia clínica de éstos y descartar el sobrediagnóstico en el cáncer de próstata.</p> <span class="elsevierStyleSectionTitle">Material y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Revisamos las historias clínicas de 61 pacientes con al menos tres o más biopsias de próstata transrectales, sextantes o de saturación según el esquema preestablecido, desde el año 2000 al 2006. Las variables analizadas son: edad del paciente, PSA, cociente PSA libre/PSA total, PSA densidad, tacto rectal, volumen prostático, hallazgos ecográficos y lesión premaligna fuertemente asociadas a la presencia de tumor en biopsias previas. Y estudiamos la anatomía patológica de los tumores diagnosticados a partir de la tercera biopsia, abordaje terapéutico y su evolución con un seguimiento mínimo de 3 meses.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">De 61 pacientes con más de tres biopsias, a 15 pacientes se les diagnostica cáncer (24,6%) en la tercera biopsia. A 14 se les realiza nueva biopsia (cuarta), encontrando tumor en 5 de ellos (35,7%). Se realiza quinta biopsia en 2 pacientes siendo positiva en uno de ellos (50%). Según los resultados de la biopsia, 6 pacientes presentaban criterios de cáncer clínicamente no significativo (28,6%). En todos los pacientes se procedió a tratamiento curativo: 5 braquiterapia, 6 radioterapia externa y a 10 se les realizó una prostatectomía radical, que evidenció tumores clínicamente significativos: 2 tumores pT2b y 7 tumores pT2c sin invasión de los márgenes quirúrgicos y con un excelente control de la enfermedad tras un seguimiento mínimo de 13 meses y un pT4 por invasión del cuello vesical.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En nuestro medio, la tercera, cuarta y quinta biopsia alcanza una positividad del 34,42% y se corresponde con tumores que se benefician de un tratamiento con intención curativa.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To study of histological and clinical features of prostate cancer diagnosed after three or more prostate biopsies in order to assess its clinical relevance and to discard the overdiagnosis of prostate cancer.</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We reviewed the clinical records of 61 patients who underwent three or more prostate biopsies between January 2000 and December 2006. The analyzed variables were: age, PSA level, free/total PSA ratio, PSA density, digital rectal examination, prostate volume, sonographic findings and previous malignant lesion strongly associated to the presence of tumor on previous biopsy. We studied the pathology of the tumors diagnosed from the third biopsy, therapeutical approach and its evolution with a minimum follow-up of 3 months.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Fifteen out of 61 patients with more than three biopsies had prostate cancer (24,59%) in the third biopsy, 5 out of 14 patients with 4 biopsies (35,71%) and 1 of the 2 cases (50%) who underwent a fifth biopsy. According to the results of biopsy, 6 patients met the criteria of clinically insignificant cancer (28,57%). Curative treatment was performed in all patients: brachytherapy in 5, external beam radiotherapy in 6 and radical prostatectomy in 10. Clinically significant tumors were found in all cases: 2 pT2b tumors and 7 pT2c tumors with negative surgical margins and with an excellent control of the cancer after a minimum follow up of 13 months, and one pT4 tumor with bladder neck infiltration.</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In our practice, overall detection rate of the third, fourth and fifth biopsy is 34,42% corresponding with tumors that could benefit from curative treatment.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:22 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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Características clínicas e histopatológicas del cáncer de próstata diagnosticado a partir de la tercera biopsia
Clinical features and histopathology of prostate cancer diagnosed from the third biopsy
M.P. Bahílo Mateu1
, M. Ramírez Backhaus, M. Trassierra Villa, C. Di Capua Sacoto, S. Arlandis Guzmán, J.F. Jiménez Cruz
Autor para correspondencia
pilarbahilo@comv.es
Correspondencia autor: Dra. M.P. Bahílo Mateu Servicio de Urología. Hospital Universitario La Fe Avda. Campanar, 21- 46009. Valencia. Tel.: 963 862 700
Correspondencia autor: Dra. M.P. Bahílo Mateu Servicio de Urología. Hospital Universitario La Fe Avda. Campanar, 21- 46009. Valencia. Tel.: 963 862 700
Servicio de Urología. Hospital Universitario La Fe. Valencia