Dear Editor,The global population of individuals aged 65 and older is projected to reach 1.6 billion by 2050[1].Given that urinary tumors,such as bladder cancer(BCa),kidney cancer(KCa),and prostate cancer(PCa),are mor...Dear Editor,The global population of individuals aged 65 and older is projected to reach 1.6 billion by 2050[1].Given that urinary tumors,such as bladder cancer(BCa),kidney cancer(KCa),and prostate cancer(PCa),are more common in older adults,the burden on the healthcare system is increasing[2].Recently,Zi et al.[3]conducted a comprehensive assessment of the global burden of 6 urinary diseases from 1990 to 2021,based on the Global Burden of Diseases,Injuries,and Risk Factors Study 2021.展开更多
This systematic review was performed to compare the efficacy and complications of transperineal （TP） vs. transrectal （TR） prostate biopsy. A systematic research of PUBM ED, EMBASE and the Cochrane Library was perf...This systematic review was performed to compare the efficacy and complications of transperineal （TP） vs. transrectal （TR） prostate biopsy. A systematic research of PUBM ED, EMBASE and the Cochrane Library was performed to identify all clinical controlled trials on prostate cancer （PCa） detection rate and complications achieved by TP and TR biopsies. Prostate biopsies included sextant, extensive and saturation biopsy procedures. All patients were assigned to a TR group and a TP group. Subgroup analysis was performed according to prostate-specific antigen （PSA） levels and digital rectal examination （DRE） findings. The Cochrane Collaboration＇s RevMan 5.1 software was used for the meta-analysis. A total of seven trials, including three randomized controlled trials （RCTs） and four casecontrol studies （CCS）, met our inclusion criteria. There was no significant difference in the cancer detection rate between the sextant TR and TP groups （risk difference （RD）, -0.02; 95% confidence interval （CI）, -0.08-0.03; P=0.34）. Meta-analysis for RCTs combined with CCS showed that there was no difference in the cancer detection rate between the extensive TR and TP group （RD, -0.01; 95% CI, -0.05-0.04; P=0.81）. There was no significant difference in PCa detection rate between the saturation TR and TP approaches （31.4% vs. 25.7%, respectively;P=0.3）. There were also no significant differences in cancer detection between the TR and TP groups in each subgroup. Although the data on complications were not pooled for the meta-analysis, no significant difference was found when comparing TR and TP studies. TR and TP biopsies were equivalent in terms of efficiency and related complications. TP prostate biopsy should be an available and alternative procedure for use by urologists.展开更多
基金supported by the Chinese Scholarship Council(202206240086,202406240158).
文摘Dear Editor,The global population of individuals aged 65 and older is projected to reach 1.6 billion by 2050[1].Given that urinary tumors,such as bladder cancer(BCa),kidney cancer(KCa),and prostate cancer(PCa),are more common in older adults,the burden on the healthcare system is increasing[2].Recently,Zi et al.[3]conducted a comprehensive assessment of the global burden of 6 urinary diseases from 1990 to 2021,based on the Global Burden of Diseases,Injuries,and Risk Factors Study 2021.
基金This review was supported by Nationnal Natural Science Foundation of China （NSFC 81172439）.
文摘This systematic review was performed to compare the efficacy and complications of transperineal （TP） vs. transrectal （TR） prostate biopsy. A systematic research of PUBM ED, EMBASE and the Cochrane Library was performed to identify all clinical controlled trials on prostate cancer （PCa） detection rate and complications achieved by TP and TR biopsies. Prostate biopsies included sextant, extensive and saturation biopsy procedures. All patients were assigned to a TR group and a TP group. Subgroup analysis was performed according to prostate-specific antigen （PSA） levels and digital rectal examination （DRE） findings. The Cochrane Collaboration＇s RevMan 5.1 software was used for the meta-analysis. A total of seven trials, including three randomized controlled trials （RCTs） and four casecontrol studies （CCS）, met our inclusion criteria. There was no significant difference in the cancer detection rate between the sextant TR and TP groups （risk difference （RD）, -0.02; 95% confidence interval （CI）, -0.08-0.03; P=0.34）. Meta-analysis for RCTs combined with CCS showed that there was no difference in the cancer detection rate between the extensive TR and TP group （RD, -0.01; 95% CI, -0.05-0.04; P=0.81）. There was no significant difference in PCa detection rate between the saturation TR and TP approaches （31.4% vs. 25.7%, respectively;P=0.3）. There were also no significant differences in cancer detection between the TR and TP groups in each subgroup. Although the data on complications were not pooled for the meta-analysis, no significant difference was found when comparing TR and TP studies. TR and TP biopsies were equivalent in terms of efficiency and related complications. TP prostate biopsy should be an available and alternative procedure for use by urologists.
