Strategy for Repeat Prostate Biopsy: Predictors of Positive Biopsy and Additional Biopsy Location

Katto, Kazunobu; Takahashi, Masayuki; Taue, Ryuichi; Nakatsuji, Hiroyoshi; Kishimoto, Tomoteru; Ishikawa, Hirofumi; Oka, Nariko; Fukumori, Tomoharu; Nishitani, Masaaki; Kanayama, Hiro‐omi

doi:10.1159/000144056

Cited by 3 publications

(4 citation statements)

References 38 publications

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“…These data suggest that biopsy interval cannot be recommended and it should be considered PCa detection rate at a repeat biopsy vary from 10% to 40% in different studies. [4][5][6][7][8] On the whole, overall PCa detection rate (22.12%) in the current study is consistent with the results in other studies. Similar fi ndings were noted by other investigators with cancer detection rate ranging from 22.5% to 26.5%.…”

Section: Discussionsupporting

confidence: 92%

“…According to Katto et al additional biopsy cores taken from transitional zone and anterior apex of the prostate, performed as a repeat biopsy, are more likely to give positive histological result. 6 In general, our data suggest that the detection rate for the target group of subsequent biopsies is lower and TURP has a greater detection rate of PCa in patients with previously negative biopsies. We strongly recommend TURP in patients with persistently increased or increasing serum PSA level in the "gray zone" and without palpable suspicion for PCa.…”

Section: Discussionmentioning

confidence: 52%

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Repeat transrectal prostate biopsies in diagnosing prostate cancer

Bakardzhiev¹,

Dechev²,

Wenig³

et al. 2012

Folia Medica

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Patients with negative prostate biopsy and persistent suspicion of prostate cancer (PCa) can pose a serious diagnostic problem. The AIM of our study was to determine the frequency of PCa found on repeat prostate biopsy and the factors leading to higher possibility of cancer positive histological result. PATIENTS AND METHODS: We studied retrospectively 113 patients (82 from University Clinic, Jena, Germany and 31 from Department of Urology, Plovdiv, Bulgaria) with initial negative biopsy for cancer who underwent repeat biopsies. The patients were examined between January 1999 and May 2010. The target group included patients with Prostate Specific Antigen (PSA) level lower than 12.5 ng/ml and without suspicious finding on digital rectal examination (DRE). Different biopsy schemes were used in the initial and the following biopsies, depending on patient age and total prostate volume. RESULTS: Overall PCa detection rate was 22.1% (25 of 113). The repeat biopsy found PCa in 15.9% (18 of 113). In patients with 3 biopsies the PCa detection rate was considerably lower - only 8.6% (3 of 35). PCa was found in only 1 patient of 18 (5.5%) who underwent four or more biopsies. Transurethral resection of the prostate (TURP) was performed in 15 patients with at least two previously negative biopsies. The pathohistological examination of the resected tissue showed PCa in 3 of the patients (20%). CONCLUSION: The interval between biopsies is not a significant predictive factor for positive prostate biopsy. The chance for detecting PCa after the second negative transrectal biopsy procedure is low. Therefore, TURP can be used as an alternative procedure to harvest adequate tissue material for pathologic examination, especially in patients with obstructive voiding symptoms.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 52%

Repeat transrectal prostate biopsies in diagnosing prostate cancer

Bakardzhiev¹,

Dechev²,

Wenig³

et al. 2012

Folia Medica

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“…There is much variation in the reported rate of prostate cancer detection on repeat biopsy, ranging from as low as 8.7% [9,10] to as high as 55.5% for aggressive techniques such as transperineal template biopsy [11–13]. Consistent with previous studies [1–6], in the present study, age, PSA and prostate volume were significantly associated with prostate cancer detection rates.…”

Section: Discussionsupporting

confidence: 86%

“…Katto et al. [11] mapped the distribution of tumour in radical prostatectomy specimens after repeat biopsy and compared this with tumour maps of patients with a positive initial biopsy. They found that tumours detected on repeat biopsy were primarily located at the periurethral area of the apex.…”

Section: Discussionmentioning

confidence: 99%

Type of transrectal ultrasonography probe influences prostate cancer detection rates on repeat prostate biopsy

Ching¹,

Zaytoun²,

Moussa³

et al. 2011

BJU International

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What ' s known on the subject? and What does the study add? It is known that the end-fi re probe detects more prostate cancer on initial prostate biopsy, but there is no literature looking at the infl uence of type of probe on repeat biopsy.Given that the literature on the infl uence of ultrasonography probe on repeat prostate biopsy is non-existent, the present study adds information which may help urologists improve their chances of detecting prostate cancer on prostate biopsy. Determining which type of probe to use on a prostate biopsy is a simple external factor that may help improve patient management. OBJECTIVE• To determine if the type of transrectal ultrasonography (TRUS) probe used during repeat prostate biopsy infl uences prostate cancer detection rates. PATIENTS AND METHODS• We conducted a retrospective chart review of 680 men undergoing repeat prostate biopsy at our institution between 2000 and 2010.• Patient mean (range) age was 64.2 (39 -95) years.• The median (range) prostate-specifi c antigen (PSA) level was 5.5 (0.37 -33.8) ng/ mL and median (range) free PSA was 17 (5 -45) %.• Patient age, PSA, prostate volume, number of biopsy cores, time interval between initial and repeat biopsy, digital rectal examination and pathological fi ndings were all included in a multivariate logistic regression analysis. RESULTS• The use of an end-fi re probe on repeat biopsy signifi cantly increased prostate cancer detection (odds ratio [ OR ] 1.59, 95% confi dence interval [ CI ] : 1.03 -2.46).• The time interval between 1 st and 2 nd biopsy was also signifi cant (OR 1.46, 95% CI: 1.11 -1.09).• On univariate analysis, white race (OR 0.66, 95% CI: 0.44 -0.99), increasing prostate volume (OR 0.70, 95% CI: 0.55 -0.89), and higher free PSA (OR 0.54, 95% CI: 0.34 -0.84) were associated with a decreased risk of cancer.• When evaluating the different permutations of using an end-fi re or side-fi re probe on initial or repeat biopsy, there was no difference in prostate cancer detection regardless of order of use of an end-fi re or side-fi re probe. CONCLUSIONS• An end-fi re probe is associated with improved prostate cancer detection rates on both initial and repeat biopsy.• The order of probe use does not appear to matter. KEYWORDSend-fi re probe , equipment , prostate biopsy , prostatic neoplasms , side-fi re probe , transrectal ultrasonography Study Type -Diagnostic (case series) Level of Evidence 4

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