Detection of prostate cancer by TURP or open surgery in patients with previously negative transrectal prostate biopsies

Zigeuner, Richard; Schips, Luigi; Lipsky, Katja; Auprich, Marco; Salfellner, Michael; Rehak, Peter; Pummer, Karl; Hubmer, G.

doi:10.1016/s0090-4295(03)00663-0

Cited by 54 publications

(45 citation statements)

References 22 publications

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“…In our study, eight out of 14 patients were offered TURP as a diagnostic procedure. A more recent retrospective review by Zigeuner et al 16 has shown a cancer detection rate by TURP in patients with two or more biopsies to be 7.6% (10 out of 28 patients), but this paper did not comment on the significance of cancer detected on TURP.…”

Section: Discussionmentioning

confidence: 81%

Role of transition zone sampling by TURP in patients with raised PSA and multiple negative transrectal ultrasound-guided prostatic biopsies

Radhakrishnan

Dorkin

Sheikh

et al. 2004

Prostate Cancer Prostatic Dis

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The purpose of the study was to determine the role of transurethral resection of the prostate (TURP) to detect prostate cancer in patients with consistently negative transrectal ultrasound-guided biopsies of the prostate. We retrospectively identified and analysed the patients who also had at least two sets of transrectal ultrasound guided sextant prostate biopsies before their TURP during the period between 1998 and 2002. A total of 14 such patients were identified and the outcome of TURP was analysed. Three patients were found to have cancer in the resected specimen (3/14 ¼ 21%). All three cancers were significant (Gleason scores between 6 and 8) and required further treatment. In patients who have rising levels of prostate-specific antigen and who have had multiple negative peripheral zone biopsies, the presence of biologically important transition zone cancers needs to be considered. This can be detected by transurethral resection of the prostate that samples the transition zone of the prostate.

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Section: Discussionmentioning

confidence: 81%

Role of transition zone sampling by TURP in patients with raised PSA and multiple negative transrectal ultrasound-guided prostatic biopsies

Radhakrishnan

Dorkin

Sheikh

et al. 2004

Prostate Cancer Prostatic Dis

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“…23 However, a consistent number of PCa, not found by biopsy, are subsequently diagnosed by TURP or open adenomectomy. For this reason, after multiple negative biopsy series, some authors have suggested to perform a TURP, even in men not complaining LUTS: Radhakrishnan et al 24 Zigeuner et al 25 and Puppo et al 3 reported a PCa detection after TURP of 21, 7.9 and 42.8%, respectively. Recently, van Renterghem et al 26 in 82 patients with minor LUTS but elevated PSA levels evaluated the clinical benefits of TURP by assessing its effect on IPSS, PSA levels and cancer detection rate: they reported an incidental PCa in 9.8% of cases, whereas PSA levels and IPSS score in patients with BPH decreased to 1.1 and 1.5 ng ml À1 , respectively.…”

Section: Discussionmentioning

confidence: 99%

Prostate cancer detection by TURP after repeated negative saturation biopsy in patients with persistent suspicion of cancer: a case–control study on 75 consecutive patients

Pepe

Fraggetta

Galia

et al. 2009

Prostate Cancer Prostatic Dis

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To evaluate prostate cancer (PCa) detection after repeated negative saturation biopsy, 75 patients, aged 53-78 years, underwent transurethral resection of prostate (TURP) because of persistent suspicion of cancer; median PSA was 11.8 ng ml À1 and 58 men complained lower urinary tract symptoms (LUTS). In 12 (16%) and 3 (4%) men a T1a and T1b PCa was found with median PSA and Gleason score equal to 14.2 vs 23.6 ng ml À1 and 5.6 vs 7 ng ml À1 . In case of persistent suspicion of PCa after repeated negative saturation biopsy, TURP may be proposed, aside from the coexistence of LUTS, to rule out a PCa, in younger patients with high PSA values (X20 ng ml À1 ).

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“…La sensibilidad del tacto rectal es reducida, ya que hasta el 50% de los pacientes se diagnostican en estadio T1c. El PSA presenta una baja especificidad, ya que se trata de una molécula órgano-específica y no cáncer-especí-fica y su elevación puede ser ocasionada por otros procesos distintos al CaP 1,7 .…”

Section: Discussionunclassified

“…A consecuencia de la baja sensibilidad de la BP convencional, la probabilidad de realización de una segunda biopsia es elevada (13-41%), alcanzando el 60% en caso de PIN 5 . En la segunda BP, la tasa de detección de CaP es del 10-19%, siendo habitualmente inferior al 10% en la tercera biopsia y sucesivas 1,6 .…”

Section: Discussionunclassified

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Importancia de la velocidad y la densidad de PSA en la predicción de cáncer de próstata en la pieza de RTU o adenomectomía de pacientes con biopsia prostática previa negativa

Alonso¹,

Blanco

López³

et al. 2008

Actas Urol Esp

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relacionadas con el hallazgo de cáncer de próstata (CaP) en pacientes sometidos a cirugía prostática tras al menos una biopsia prostática (BP) negativa.Material y métodos: Estudio retrospectivo de 170 pacientes sometidos a resección transuretral de próstata (RTUP) o adenomectomía entre 1999 y 2007, después de una o más BPs negativas. Se realizó un análisis multivariado de regresión logística para identificar variables relacionadas con la presencia de CaP. La capacidad predictiva de PSA, PSA densidad y PSA velocidad se determinó mediante curvas ROC y su área bajo la curva (ABC). Se analizó la sensibilidad, especificidad y valores predictivos para diversos puntos de corte de PSA densidad y PSA velocidad.Resultados: Se realizó adenomectomía en 104 pacientes (61,18%) y RTUP en 66 (38,82%). Se detectó CaP en la pieza quirúrgica de 16 pacientes (9,41%). Las variables asociadas al hallazgo de CaP en la pieza quirúrgica fueron PSA densidad (OR:1,47;95%IC:1,22-6,64;p:0,007) y PSA velocidad (OR:2,87;95%IC:1,60-5,12;p<0,001). Las ABC ROC fueron 0,746, 0,793 y 0,832, para PSA, PSA densidad y PSA velocidad, respectivamente. Los puntos de corte de PSA densidad y PSA velocidad con mayor sensibilidad y especificidad en la detección de CaP fueron 0,15 y 1 ng/ml/año, respectivamente. Los pacientes sin CaP mostraron una reducción mediana de PSA de 9,35 ng/ml (-2,40 -35,40), después de la cirugía.Conclusiones: El PSA densidad y el PSA velocidad en particular, permiten predecir la presencia de CaP en la pieza de RTUP o adenomectomía, de pacientes con BPs previas negativas. La RTUP diagnóstica podría ser recomendada en pacientes con sospecha clínica de CaP, susceptibles de tratamiento curativo, con PSA velocidad >1ng/ml/año y una o más biopsias de saturación previas negativas.Palabras clave: Neoplasia de próstata. Biopsia. Resección transuretral de próstata. Antígeno prostático específico. Diagnóstico. ABSTRACT IMPORTANCE OF PSA VELOCITY AND PSA DENSITY IN THE PREDICTION OF PROSTATE CANCER IN TURP OR OPEN PROS-TATECTOMY SPECIMEN OF PATIENTS WITH PREVIOUS NEGATIVE PROSTATE BIOPSY Purpose:To determine variables related to the finding of prostate cancer (PC) in patients who underwent surgery following at least one negative prostate biopsy (PB).Materials and methods: A retrospective study of 170 patients who underwent transurethral resection of the prostate (TURP) or open prostatectomy between 1999 and 2007, following one or more negative PB sets. A multivariate logistic regression analysis was carried out in order to determine variables related to the finding of PC. The predictive capacity of PSA, PSA-density and PSA-velocity was assessed by means of ROC curves and the area under the curve (AUC). Sensitivity, specificity and predictive values were determined for several PSA-density and PSA-velocity cut-off points.Results: Open prostatectomy was carried out on 104 patients (61.18%) and TURP on 66 (38.82%). PC was detected in the surgical specimen of 16 patients (9.41%). Variables associated with the finding of PC in the surgical specimen...

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Detection of prostate cancer by TURP or open surgery in patients with previously negative transrectal prostate biopsies

Cited by 54 publications

References 22 publications

Role of transition zone sampling by TURP in patients with raised PSA and multiple negative transrectal ultrasound-guided prostatic biopsies

Role of transition zone sampling by TURP in patients with raised PSA and multiple negative transrectal ultrasound-guided prostatic biopsies

Prostate cancer detection by TURP after repeated negative saturation biopsy in patients with persistent suspicion of cancer: a case–control study on 75 consecutive patients

Importancia de la velocidad y la densidad de PSA en la predicción de cáncer de próstata en la pieza de RTU o adenomectomía de pacientes con biopsia prostática previa negativa

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