Accuracy of <scp>HistoScanning</scp> ™ for the prediction of a negative surgical margin in patients undergoing radical prostatectomy

Abstract

What's known on the subject? and What does the study add? HistoScanning ™ is a novel ultrasonography technique for visualization of prostate cancer. The technology it uses and its encouraging results in prostate cancer foci detection in 29 men with prostate cancer have been described previously. A recent study confirmed these results in 31 patients. The sensitivity and specificity of prostate cancer foci detection were 90% and 72%, respectively. These promising results raised the question of whether HistoScanning ™ technology might also be helpful in therapy planning. Preoperative knowledge of the distribution and size of tumours might be useful for treatment planning of a nerve‐sparing radical prostatectomy. We tested the ability of HistoScanning ™ to predict a negative surgical margin in 80 patients undergoing radical prostatectomy. Objective To assess the accuracy of HistoScanning ™ ( HS ) as a visualization tool for preoperative treatment planning for nerve‐sparing ( NS ) radical prostatectomy ( RP ). Patients and Methods A retrospective study was carried out on 80 patients with prostate cancer undergoing RP from O ctober 2009 to D ecember 2009. All patients underwent a HS procedure 1 day before surgery. Frozen sections ( FSs ) were performed on each latero‐posterior side of the prostate to assess for the presence of cancer. On the HS analysis, the region corresponding to that removed at FS was assessed for suspicious lesions. The size of suspicious lesions within this volume was compared with the FS histopathological analysis. Results HS results corresponded to a 93% probability of having a negative surgical margin in the FSs . The presence of a HS volume ≥0.2 mL in a specific side was associated with a 3.7 times increased risk of a positive surgical margin at FS . Conclusions HS has the potential to assist in the planning of NSRP . Larger, multicentre studies need to be performed for validation of these encouraging results.