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Patterns of repeat prostate biopsy in contemporary clinical practice
Nitya E Abraham1, Neil Mendhiratta1, Samir S Taneja1
1Division of Urologic Oncology, Department of Urology, New York University School of Medicine, New York, New York.
The Journal of Urology
|December 3, 2014
Summary
Repeat prostate biopsies can detect clinically significant cancer, even after multiple attempts. Older men and those with more biopsy cores have a higher likelihood of diagnosis, suggesting earlier advanced biopsy techniques may be beneficial.
Area of Science:
- Urology
- Oncology
- Diagnostic Imaging
Background:
- Prostate cancer diagnosis often requires repeat biopsies after an initial negative result.
- Understanding patterns and predictors of repeat biopsy outcomes is crucial for patient management.
Purpose of the Study:
- To describe repeat prostate biopsy patterns in men with prior negative biopsies.
- To identify predictors of prostate cancer diagnosis on repeat prostate biopsy.
Main Methods:
- Retrospective analysis of 1,837 men undergoing prostate biopsy (1995-2010).
- Examined repeat biopsy characteristics (indication, cores, PSA) and cancer features (Gleason score, positive cores).
- Multivariable logistic regression used to identify cancer predictors.
Main Results:
- 1,213 men had initial negative biopsies; 255 underwent 798 repeat biopsies.
- Prostate cancer was diagnosed in 63 men on repeat biopsy.
- Older age (>70), >20 cores, and the fourth repeat biopsy increased cancer detection likelihood.
Conclusions:
- Clinically significant prostate cancer is detected in repeat biopsies.
- Cancer detection persists even by the fifth biopsy.
- Consideration of saturation or image-guided biopsy is warranted for repeat biopsy candidates.
