Prostate biopsy patterns in the CaPSURE database: evolution with time and impact on outcome after prostatectomy

Area of Science:

• Urology
• Oncology
• Pathology

Background:

• Prostate biopsy core numbers vary among urologists.
• Assessing biopsy patterns and their impact on prostate cancer treatment outcomes is crucial.

Purpose of the Study:

• To analyze trends in prostate biopsy patterns over a decade.
• To determine if changes in biopsy core numbers affect outcomes after radical prostatectomy.

Main Methods:

• Utilized CaPSURE database (1995-2004) with 6,450 men undergoing prostate biopsy.
• Analyzed core numbers, positive cores, and percentage of positive cores by year.
• Used Cox models for 1,757 men undergoing radical prostatectomy to predict recurrence-free survival.

Main Results:

• Mean removed cores increased from 6.9 to 10.2 (p <0.0001).
• Mean positive cores remained stable (2.9 to 3.2, p = 0.40).
• Percentage of positive cores decreased from 42.6% to 32.1% (p <0.0001).
• Positive core number and percentage predicted recurrence-free survival (p <0.001).

Conclusions:

• The percentage of positive cores independently predicts disease recurrence post-radical prostatectomy.
• Increased total cores sampled led to a lower mean percentage of positive cores.
• Rising core counts may indirectly enhance outcomes after radical prostatectomy.