|
|
|
| The risk of prostate cancer on incidental finding of an avid prostate uptake on 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography for non-prostate cancer-related pathology: A single centre retrospective study |
Anthony Franklina,b,c,Troy Gianduzzoa,c,Boon Kuaa,David Wongd,Louise McEwand,James Waltersd,Rachel Eslera,e,Matthew J. Robertse,Geoff Coughlina,John W. Yaxleya,c,e,*( )
|
aDepartment of Urology, The Wesley Hospital, Brisbane, QLD, Australia
bWesley Medical Research, Brisbane, QLD, Australia
cSchool of Medicine, The University of Queensland, Brisbane, QLD, Australia
dDepartment of Radiology, Wesley Medical Imaging, Brisbane, QLD, Australia
eDepartment of Urology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia |
|
|
|
|
Abstract Objective: To review the risk of prostate cancer (PCa) in men with incidentally reported increased intraprostatic uptake at 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) ordered at Department of Urology, The Wesley Hospital, Brisbane, QLD, Australia for non-PCa related pathology. Methods: Retrospective analysis of consecutive men between August 2014 and August 2019 presenting to a single institution for 18F- FDG PET/CT for non-prostate related conditions was conducted. Men were classified as benign, indeterminate, or malignant depending of the results of prostate-specific antigen (PSA), PSA velocity, biopsy histopathology, and three-Tesla (3 T) multiparametric MRI (mpMRI) Prostate Imaging Reporting and Data System score, or gallium-68-prostate-specific membrane antigen (68Ga-PSMA) PET/CT results. Results: Three percent (273/9122) of men demonstrated 18F-FDG avidity within the prostate. Eighty-five percent (231/273) were further investigated, including with PSA tests (227/231, 98.3%), 3 T mpMRI (68/231, 29.4%), 68Ga-PSMA PET/CT (33/231, 14.3%), and prostate biopsy (57/231, 24.7%). Results were considered benign in 130/231 (56.3%), indeterminate in 31/231 (13.4%), and malignant in 70/231 (30.3%). PCa was identified in 51/57 (89.5%) of the men who proceeded to biopsy, including 26/27 (96.3%) men with Prostate Imaging Reporting and Data System scores 4-5 mpMRI and six men with a positive 68Ga-PSMA PET/CT. The most common Gleason score on biopsy was greater than or equal to 4+5 (14/51, 27.5%). 68Ga-PSMA PET/CT was concordant with the 18F-FDG findings in 26/33 (78.8%). All 13 men with a positive concordant 18F-FDG, 3 T mpMRI, and 68Ga-PSMA PET/CT had PCa on biopsy. There was no statistically significant difference in the 18F-FDG maximum standardized uptake value between the benign or malignant groups (5.7 vs. 6.1; p=0.580). Conclusion: In this study, after an incidental finding of an avid intraprostatic lesion on 18F- FDG PET/CT, 70 of the 231 cases (30.3%; 0.8% of the entire cohort) had results consistent with PCa, most commonly as Gleason score greater than or equal to 4+5 disease. Unless there is limited life expectancy due to competing medical co-morbidity, men with an incidental finding of intraprostatic uptake on 18F-FDG should be further investigated using principles of PCa detection.
|
|
Received: 26 July 2021
Available online: 20 January 2024
|
|
Corresponding Authors:
*Department of Urology, The Wesley Hospital, Brisbane, QLD, Australia. E-mail address: dryaxley@wesleyurologyclinic.com.au (J.W. Yaxley).
|
|
|
|
|
Flow diagram of distribution of groups by definitions. 18F-FDG, 2-deoxy-2-[18F]fluoro- D-glucose; PET/CT, positron emission tomography/computed tomography; PSA, prostate-specific antigen; mpMRI, multiparametric MRI; 68Ga- PSMA, Gallium-68 prostate-specific membrane antigen; TPBx, transperineal prostate biopsy; PSADT, PSA doubling time; PIRADS, Prostate Imaging Reporting and Data System; ADT, androgen deprivation therapy; 3 T, three-Tesla.
|
| Characteristic | Malignant | Benign | Indeterminate | Total | | Patient, n (%) | 70 (30.3) | 130 (56.3) | 31 (13.4) | 231 (100) | | Age, median (range), year | 75 (47-97) | 73 (40-97) | 79 (59-92) | 74 (32-97) | | PSA, median (range), μg/L | 9.6 (1.2-100.0) | 1.6 (0.07-13.0) | 5.0 (2.1-52.0) | 3.6 (0.07-100.0) | | FDG SUVmax, median (range) | 6.1 (2.8-49.9) | 5.7 (2.8-54.0) | 6.8 (2.7-60.6) | 5.9 (2.7-60.6) | | mpMRI, n (%) and percent of abnormala | 35 (50.0); 88.6 | 21 (16.2); 4.8 | 12 (38.7); 16.7 | 68 (29.4); 50 | | 68Ga-PSMA, n (%) and percent of abnormala | 30 (42.9); 90 | 3 (2.3); 0 | 0 (0); 0 | 33 (14.3); 81.8 | | TPBx, n (%) and percent of abnormala | 51 (72.9); 100 | 6 (4.6); 0 | 0 (0); 0 | 57 (24.7); 89.5 |
|
|
Summary of outcomes between groups (n=231).
|
| FDG SUVmax | Biopsy Gleason score | Total | | Benign | 3+3 | 3+4 | 4+3 | 4+4 | ≥4+5 | | <6 | 2 | 6 | 5 | 5 | 2 | 11 | 31 | | 6-10 | 3 | 1 | 4 | 4 | 4 | 1 | 17 | | >10 | 1 | 1 | 4 | 1 | 0 | 2 | 9 | | Total | 6 | 8 | 13 | 10 | 6 | 14 | 57 |
|
|
Relationship between SUVmax on FDG PET and Gleason score on biopsy.
|
| Characteristic | 3 T mpMRI | 68Ga-PSMA PET/CT | | Positive | Negative | Positive | Negative | | Concordant | Non-concordant | Concordant | Non-concordant | | Patient, n (%) | 30 (90.9a) | 3 (9.1a) | 35 (51.5b) | 25 (78.1a) | 7 (21.9a) | 5 (13.5b) | | Biopsy, n | 24 | 3 | 8 | 18 | 7 | 4 | | PCa, n | 23 | 3 | 4 | 18 | 6 | 3 | | csPCa, n | 19 | 3 | 2 | 17 | 4 | 1 |
|
|
Concordance between prostate findings on18F-FDG, mpMRI, and 68Ga-PSMA PET/CT.
|
| [1] |
Lavallee E, Bergeron M, Buteau FA, Blouin AC, Duchesnay N, Dujardin T, et al. Increased prostate cancer glucose metabolism detected by 18F-fluorodeoxyglucose positron emission tomography/computed tomography in localised gleason 8e10 prostate cancers identifies very high-risk patients for early recurrence and resistance to castration. Eur Urol Focus 2019; 5:998-1006.
doi: 10.1016/j.euf.2018.03.008
|
| [2] |
Bensinger SJ, Christofk HR. New aspects of the Warburg effect in cancer cell biology. Semin Cell Dev Biol 2012; 23:352-61.
doi: 10.1016/j.semcdb.2012.02.003
pmid: 22406683
|
| [3] |
Kwon T, Jeong IG, You D, Hong JH, Ahn H, Kim CS. Prevalence and clinical significance of incidental 18F-fluoro-2-deoxyglucose uptake in prostate. Korean J Urol 2015; 56:288-94.
doi: 10.4111/kju.2015.56.4.288
|
| [4] |
Makis W, Ciarallo A. Clinical significance of 18F-fluorodeoxyglucose avid prostate gland incidentalomas on positron emission tomography/computed tomography. Mol Imaging Radionucl Ther 2017; 26:76-82.
doi: 10.4274/Mirt
|
| [5] |
Hwang I, Chong A, Jung SI, Hwang EC, Kim SO, Kwon TW, et al. Is further evaluation needed for incidental focal uptake in the prostate in 18-fluoro-2-deoxyglucose positron emission tomography-computed tomography images? Ann Nucl Med 2013; 27:140-5.
doi: 10.1007/s12149-012-0663-7
pmid: 23076866
|
| [6] |
Sahin E, Elboga U, Kalender E, Basibuyuk M, Demir HD, Celen YZ. Clinical significance of incidental FDG uptake in the prostate gland detected by PET/CT. Int J Clin Exp Med 2015; 8:10577-85.
pmid: 26379847
|
| [7] |
Eidelman E, Twum-Ampofo J, Ansari J, Siddiqui MM. The metabolic phenotype of prostate cancer. Front Oncol 2017; 7:131. https://doi.org/10.3389/fonc.2017.00131.
doi: 10.3389/fonc.2017.00131
pmid: 28674679
|
| [8] |
Michalski K, Ruf J, Goetz C, Seitz AK, Buck AK, Lapa C, et al. Prognostic implications of dual tracer PET/CT: PSMA ligand and 18F-FDG PET/CT in patients undergoing 177Lu PSMA radioligand therapy. Eur J Nucl Med Mol Imag 2021; 48:2024-30.
doi: 10.1007/s00259-020-05160-8
|
| [9] |
McGeorge S, Kwok M, Jiang A, Emmett L, Pattison DA, Thomas PA, et al. Dual-tracer positron-emission tomography using prostate-specific membrane antigen and fluorodeoxyglucose for staging of prostate cancer: a systematic review. Adv Urol 2021; 2021:1544208. https://doi.org/10.1155/2021/1544208.
|
| [10] |
Bertagna F, Sadeghi R, Giovanella L, Treglia G. Incidental uptake of 18F-fluorodeoxyglucose in the prostate gland. Systematic review and meta-analysis on prevalence and risk of malignancy. Nuklearmedizin 2014; 53:249-58.
|
| [11] |
Raveenthiran S, Yaxley WJ, Franklin T, Coughlin G, Roberts M, Gianduzzo T, et al. Findings in 1123 Men with preoperative 68Gaprostate-specific membrane antigen positron emission tomography/computerized tomography and multiparametric magnetic resonance imaging compared to totally embedded radical prostatectomy histopathology: implications for the diagnosis and management of prostate cancer. J Urol 2022; 207:573-80.
doi: 10.1097/JU.0000000000002293
|
| [12] |
Yaxley JW, Raveenthiran S, Nouhaud FX, Samaratunga H, Yaxley WJ, Coughlin G, et al. Risk of metastatic disease on 68gallium-prostate-specific membrane antigen positron emission tomography/computed tomography scan for primary staging of 1253 men at the diagnosis of prostate cancer. BJU Int 2019; 124:401-7.
doi: 10.1111/bju.14828
pmid: 31141284
|
| [13] |
Heyns C, Basson J, Van der Merwe, Zarrabi A. Clinical (nonhistological) diagnosis of advanced prostate cancer: evaluation of treatment outcome after androgen deprivation therapy. S Afr J Surg 2014; 52:82-5.
doi: 10.7196/sajs.1689
|
| [14] |
McLaren DB, McKenzie M, Duncan G, Pickles T. Watchful waiting or watchful progression?: prostate specific antigen doubling times and clinical behavior in patients with early untreated prostate carcinoma. Cancer 1998; 82:342-8.
|
| [15] |
Yaxley AJ, Yaxley JW, Thangasamy IA, Ballard E, Pokorny MR. Comparison between target magnetic resonance imaging (MRI) in-gantry and cognitively directed transperineal or transrectal-guided prostate biopsies for Prostate Imaging-Reporting and Data System (PI-RADS)3-5 MRI lesions. BJU Int 2017; 120:43-50.
doi: 10.1111/bju.2017.120.issue-S3
|
| [16] |
Epstein JI, Allsbrook WC Jr, Amin MB, Egevad LL. The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason grading of prostatic carcinoma. Am J Surg Pathol 2005; 29:1228-42.
|
| [17] |
Epstein JI, Egevad L, Amin MB, Delahunt B, Srigley JR, Humphrey PA. The 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason grading of prostatic carcinoma: definition of grading patterns and proposal for a new grading system. Am J Surg Pathol 2016; 40:244-52.
|
| [18] |
Seino H, Ono S, Miura H, Morohashi S, Wu Y, Tsushima F, et al. Incidental prostate 18F-FDG uptake without calcification indicates the possibility of prostate cancer. Oncol Rep 2014; 31:1517-22.
doi: 10.3892/or.2014.3011
|
| [19] |
Reesink DJ, Fransen van de Putte EE, Vegt E, De Jong J, van Werkhoven E, Mertens LS, et al. Clinical relevance of incidental prostatic lesions on FDG-positron emission tomography/computerized tomographydshould patients receive further evaluation? J Urol 2016; 195:907-12.
doi: 10.1016/j.juro.2015.11.025
pmid: 26598424
|
| [20] |
Emmett L, Buteau J, Papa N, Moon D, Thompson J, Roberts MJ, et al. The additive diagnostic value of prostate-specific membrane antigen positron emission tomography computed tomography to multiparametric magnetic resonance imaging triage in the diagnosis of prostate cancer (PRIMARY): a prospective multicenter study. Eur Urol 2021; 80:682-9.
doi: 10.1016/j.eururo.2021.08.002
|
| [21] |
Bertagna F, Piccardo A, Dib B, Bertoli M, Fracassi F, Bosio G, et al. Multicentre study of 18F-FDG-PET/CT prostate incidental uptake. Jpn J Radiol 2015; 33:538-46.
doi: 10.1007/s11604-015-0453-y
|
| [22] |
Papa N, O’Callaghan M, James E, Millar J. Prostate cancer in Australia and New Zealand men: patterns of care within PCORANZ 2015-2018. Melbourne University and Movember. Melbourne, VIC; 2021. Available at: https://prostatecancerregistryorg.s3.amazonaws.com/pcor_cms/media/filer_public/ce/9c/ce9cd8eb-2cb0-4be9-8473-4087b277fb1e/pcor-anz_2020_annual_report_final.pdf. [Accessed August 10, 2021].
|
| [23] |
Samaratunga H, Delahunt B, Yaxley J, Perry-Keene J, Lamb DS, Srigley JR, et al. Clinical significance of cancer in radical prostatectomy specimens: analysis from a contemporary series of 2900 men. Pathology 2014; 46:11-4.
doi: 10.1097/PAT.0000000000000044
|
| [24] |
Jadvar H. Is there use for FDG-PET in prostate cancer? Semin Nucl Med 2016; 46:502-6.
doi: S0001-2998(16)30046-0
pmid: 27825430
|
| [25] |
McGeorge S, Kwok M, Jiang A, Emmett L, PattisonDA, Thomas PA, et al. Dual-tracer positron-emission tomography using prostatespecific membrane antigen and fluorodeoxyglucose for staging of prostate cancer: a systematic review. Adv Urol 2021; 2021:1544208. https://doi.org/10.1155/2021/1544208.
|
| [26] |
Beauregard JM, Blouin AC, Fradet V, Caron A, Fradet Y, Lemay C, et al. FDG-PET/CT for pre-operative staging and prognostic stratification of patients with high-grade prostate cancer at biopsy. Cancer Imag 2015; 15:2. https://doi.org/10.1186/s40644-015-0038-0c.
doi: 10.1186/s40644-015-0038-0
|
| [27] |
Jadvar H, Velez EM, Desai B, Ji L, Colletti PM, Quinn DI. Prediction of time to hormonal treatment failure in metastatic castration-sensitive prostate cancer with 18F-FDG PET/CT. J Nucl Med 2019; 60:1524-30.
doi: 10.2967/jnumed.118.223263
|
| [28] |
Roobol MJ, Schr?der FH, Hugosson J, Jones JS, Kattan MW, Klein EA, et al. Importance of prostate volume in the European Randomised Study of Screening for Prostate Cancer (ERSPC) risk calculators: results from the prostate biopsy collaborative group. World J Urol 2012; 30:149-55.
doi: 10.1007/s00345-011-0804-y
pmid: 22203238
|
| [29] |
Minamimoto R, Uemura H, Sano F, Terao H, Nagashima Y, Yamanaka S, et al. The potential of FDG-PET/CT for detecting prostate cancer in patients with an elevated serum PSA level. Ann Nucl Med 2011; 25:21-7.
doi: 10.1007/s12149-010-0424-4
pmid: 20931305
|
| [30] |
Brown AM, Lindenberg ML, Sankineni S, Shih JH, Johnson LM, Pruthy S, et al. Does focal incidental 18F-FDG PET/CT uptake in the prostate have significance? Abdom Imag 2015; 40:3222-9.
doi: 10.1007/s00261-015-0520-y
|
| [31] |
Morgan TM, Welty CJ, Vakar-Lopez F, Lin DW, Wright JL. Ductal adenocarcinoma of the prostate: increased mortality risk and decreased serum prostate specific antigen. J Urol 2010; 184:2303-7.
doi: 10.1016/j.juro.2010.08.017
pmid: 20952027
|
| [32] |
Donato P, Morton A, Yaxley J, Ranasinghe S, Teloken PE, Kyle S, et al. 68Ga-PSMA PET/CT better characterises localized prostate cancer after MRI and transperineal prostate biopsy: is 68Ga-PSMA PET/CT guided biopsy the future? Eur J Nucl Med Mol Imag 2020; 47:1843-51.
doi: 10.1007/s00259-019-04620-0
|
| [33] |
D’Amico AV, Chen MH, Roehl KA, Catalona WJ. Preoperative PSA velocity and the risk of death from prostate cancer after radical prostatectomy. N Engl J Med 2004; 351:125-35.
doi: 10.1056/NEJMoa032975
|
| [34] |
Egawa S, Arai Y, Tobisu K, Kuwao S, Kamoto T, Kakehi Y, et al. Use of pretreatment prostate-specific antigen doubling time to predict outcome after radical prostatectomy. Prostate Cancer Prostatic Dis 2000; 3:269-74.
doi: 10.1038/sj.pcan.4500424
|
| [35] |
Khatami A, Aus G, Damber JE, Lilja H, Lodding P, Hugosson J. PSA doubling time predicts the outcome after active surveillance in screening-detected prostate cancer: results from the European randomized study of screening for prostate cancer, Sweden section. Int J Cancer 2007; 120:170-4.
pmid: 17013897
|
| [36] |
Vickers AJ, Savage C, O’Brien MF, Lilja H. Systematic review of pretreatment prostate-specific antigen velocity and doubling time as predictors for prostate cancer. J Clin Oncol 2009; 27:398-403.
doi: 10.1200/JCO.2008.18.1685
pmid: 19064972
|
| [37] |
Vickers AJ, Brewster SF. PSA velocity and doubling time in diagnosis and prognosis of prostate cancer. Br J Med Surg Urol 2012; 5:162-8.
doi: 10.1016/j.bjmsu.2011.08.006
|
| [1] |
Michele Marchioni, Giulia Primiceri, Alessandro Veccia, Marta Di Nicola, Umberto Carbonara, Fabio Crocerossa, Ugo Falagario, Ambra Rizzoli, Riccardo Autorino, Luigi Schips. Transurethral prostate surgery in prostate cancer patients: A population-based comparative analysis of complication and mortality rates[J]. Asian Journal of Urology, 2024, 11(1): 48-54. |
| [2] |
Jonathan Noël, Daniel Stirt, Marcio Covas Moschovas, Sunil Reddy, Abdel Rahman Jaber, Marco Sandri, Seetharam Bhat, Travis Rogers, Subuhee Ahmed, Anya Mascarenhas, Ela Patel, Vipul Patel. Oncologic outcomes with and without amniotic membranes in robotic-assisted radical prostatectomy: A propensity score matched analysis[J]. Asian Journal of Urology, 2024, 11(1): 19-25. |
| [3] |
Awad Elsid Osman, Sahar Alharbi, Atif Ali Ahmed, Asim Ali Elbagir. Single nucleotide polymorphism within chromosome 8q24 is associated with prostate cancer development in Saudi Arabia[J]. Asian Journal of Urology, 2024, 11(1): 26-32. |
| [4] |
Randi M. Pose, Sophie Knipper, Jonas Ekrutt, Mara Kölker, Pierre Tennstedt, Hans Heinzer, Derya Tilki, Florian Langer, Markus Graefen. Prevention of thromboembolic events after radical prostatectomy in patients with hereditary thrombophilia due to a factor V Leiden mutation by multidisciplinary coagulation management[J]. Asian Journal of Urology, 2024, 11(1): 42-47. |
| [5] |
Enrico Checcucci, Alberto Piana, Gabriele Volpi, Pietro Piazzolla, Daniele Amparore, Sabrina De Cillis, Federico Piramide, Cecilia Gatti, Ilaria Stura, Enrico Bollito, Federica Massa, Michele Di Dio, Cristian Fiori, Francesco Porpiglia. Three-dimensional automatic artificial intelligence driven augmented-reality selective biopsy during nerve-sparing robot-assisted radical prostatectomy: A feasibility and accuracy study[J]. Asian Journal of Urology, 2023, 10(4): 407-415. |
| [6] |
Roxana Ramos-Carpinteyro, Ethan L. Ferguson, Jaya S. Chavali, Albert Geskin, Jihad Kaouk. First 100 cases of transvesical single-port robotic radical prostatectomy[J]. Asian Journal of Urology, 2023, 10(4): 416-422. |
| [7] |
Umberto Carbonara, Giuseppe Lippolis, Luciano Rella, Paolo Minafra, Giuseppe Guglielmi, Antonio Vitarelli, Giuseppe Lucarelli, Pasquale Ditonno. Intermediate-term oncological and functional outcomes in prostate cancer patients treated with perineal robot-assisted radical prostatectomy: A single center analysis[J]. Asian Journal of Urology, 2023, 10(4): 423-430. |
| [8] |
Angelo Territo, Alessandro Uleri, Andrea Gallioli, Josep Maria Gaya, Paolo Verri, Giuseppe Basile, Alba Farré, Alejandra Bravo, Alessandro Tedde, Óscar Rodríguez Faba, Joan Palou, Alberto Breda. Robot-assisted oncologic pelvic surgery with Hugo™ robot-assisted surgery system: A single-center experience[J]. Asian Journal of Urology, 2023, 10(4): 461-466. |
| [9] |
Thomas Whish-Wilson, Jo-Lynn Tan, William Cross, Lih-Ming Wong, Tom Sutherland. Prostate magnetic resonance imaging and the value of experience: An intrareader variability study[J]. Asian Journal of Urology, 2023, 10(4): 488-493. |
| [10] |
Thitipat Hansomwong, Pat Saksirisampant, Sudhir Isharwal, Pubordee Aussavavirojekul, Varat Woranisarakul, Siros Jitpraphai, Sunai Leewansangtong, Tawatchai Taweemonkongsap, Sittiporn Srinualnad. Role of preoperative magnetic resonance imaging on the surgical outcomes of radical prostatectomy: Does preoperative tumor recognition reduce the positive surgical margin in a specific location? Experience from a Thailand prostate cancer specialized center[J]. Asian Journal of Urology, 2023, 10(4): 494-501. |
| [11] |
Kerri R. Beckmann, Michael E. O'Callaghan, Andrew D. Vincent, Kim L. Moretti, Nicholas R. Brook. Clinical outcomes for men with positive surgical margins after radical prostatectomy—results from the South Australian Prostate Cancer Clinical Outcomes Collaborative community-based registry[J]. Asian Journal of Urology, 2023, 10(4): 502-511. |
| [12] |
Wei He,Yutian Xiao,Shi Yan,Yasheng Zhu,Shancheng Ren. Cell-free DNA in the management of prostate cancer: Current status and future prospective[J]. Asian Journal of Urology, 2023, 10(3): 298-316. |
| [13] |
Shulin Wu,Sharron X. Lin,Kristine M. Cornejo,Rory K. Crotty,Michael L. Blute,Douglas M. Dahl,Chin-Lee Wu. Clinicopathological and oncological significance of persistent prostate-specific antigen after radical prostatectomy: A systematic review and meta-analysis[J]. Asian Journal of Urology, 2023, 10(3): 317-328. |
| [14] |
Stefano Alba,Deborah Fimognari,Fabio Crocerossa,Luigi Ascalone,Carmine Pullano,Fernando Chiaravalloti,Francesco Chiaradia,Umberto Carbonara,Matteo Ferro,Ottavio de Cobelli,Vincenzo Pagliarulo,Giuseppe Lucarelli,Michele Battaglia,Rocco Damiano,Francesco Cantiello. Neuraxial anesthesia versus general anesthesia in patients undergoing three-dimensional laparoscopic radical prostatectomy: Preliminary results of a prospective comparative study[J]. Asian Journal of Urology, 2023, 10(3): 329-336. |
| [15] |
Fabricio B. Carrerette,Daniela B. Rodeiro,Rui T. F. Filho,Paulo A. Santos,Celso C. Lara,Ronaldo Damião. Randomized controlled trial comparing open anterograde anatomic radical retropubic prostatectomy with retrograde technique[J]. Asian Journal of Urology, 2023, 10(2): 151-157. |
|
|
|
|
