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Extensive Biopsies and Transurethral Prostate Resection in Men With Previous Negative Biopsies and High or Increasing Prostate Specific Antigen

Ploussard, Guillaume ; Dubosq, Francis ; Boublil, Véronique ; Allory, Yves ; de la Taille, Alexandre ; Vordos, Dimitri ; Hoznek, Andras ; Abbou, Claude-Clément ; Salomon, Laurent

The Journal of urology, 2009-10, Vol.182 (4), p.1342-1349 [Peer Reviewed Journal]

New York, NY: Elsevier Inc

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Title:
Extensive Biopsies and Transurethral Prostate Resection in Men With Previous Negative Biopsies and High or Increasing Prostate Specific Antigen
Author: Ploussard, Guillaume ; Dubosq, Francis ; Boublil, Véronique ; Allory, Yves ; de la Taille, Alexandre ; Vordos, Dimitri ; Hoznek, Andras ; Abbou, Claude-Clément ; Salomon, Laurent
Subjects: Aged ; Aged, 80 and over ; Biological and medical sciences ; biopsy ; Biopsy, Needle - methods ; False Negative Reactions ; Gynecology. Andrology. Obstetrics ; Humans ; Male ; Male genital diseases ; Medical sciences ; Middle Aged ; Nephrology. Urinary tract diseases ; Prospective Studies ; prostate ; prostate-specific antigen ; Prostate-Specific Antigen - blood ; prostatic neoplasms ; Prostatic Neoplasms - blood ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - surgery ; Transurethral Resection of Prostate ; Tumors ; Tumors of the urinary system ; Urinary tract. Prostate gland ; Urology
Is Part Of: The Journal of urology, 2009-10, Vol.182 (4), p.1342-1349
Notes: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Description: Purpose We determined the diagnostic role of an extensive biopsy protocol associated with transurethral prostate resection in patients with persistently increased or increasing prostate specific antigen without evidence of prostate cancer after 2 or more extended negative sets of biopsies. Materials and Methods A new set of 21-core biopsies was done in 113 patients under general anesthesia in association with transurethral prostate resection. Demographics, clinical and biological data, operative parameters, pathological results and followup were recorded prospectively. Results Extended biopsies provided an 18.6% detection rate and detected 77.8% of prostate cancers. Transurethral prostate resection significantly increased the detection rate by 28.5% for an overall 23.9% prostate cancer detection rate (p = 0.035). Most prostate cancer detected on chips and/or biopsy was clinically significant and 30% were scored as Gleason 7 or greater. Of prostatectomy specimens 19% showed pT3a-pT4 cancer with a median Gleason score of 7. In patients with no cancer mean prostate specific antigen 1 year after transurethral prostate resection was 4.5 ng/ml (range 0.3 to 16.3), which remained stable during followup. A third of these patients underwent repeat biopsy with a 16.7% prostate cancer detection rate. Conclusions About a fourth of patients with at least 2 extended negative sets of prostate biopsies remain at risk for prostate cancer and most tumors missed on initial procedures are clinically significant. Repeat biopsy using general anesthesia detects three-fourths of these prostate cancers. However, the diagnostic yield of transurethral prostate resection appears significant and may provide additional data of clinical importance in select, informed patients.
Publisher: New York, NY: Elsevier Inc
Language: English

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Extensive Biopsies and Transurethral Prostate Resection in Men With Previous Negative Biopsies and High or Increasing Prostate Specific Antigen

Ploussard, Guillaume ; Dubosq, Francis ; Boublil, Véronique ; Allory, Yves ; de la Taille, Alexandre ; Vordos, Dimitri ; Hoznek, Andras ; Abbou, Claude-Clément ; Salomon, Laurent

New York, NY: Elsevier Inc

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