Transurethral resection biopsy as part of a saturation biopsy protocol: a cohort study and review of the literature.

Abstract

OBJECTIVE:

To evaluate the prostate cancer (CaP) detection rate and morbidity of performing a transurethral resection biopsy of the prostate (TURBP) at the same time as a saturation biopsy (SBx).

PATIENTS:

A total of 102 men with previous negative transrectal ultrasound (TRUS) biopsies underwent a SBx under formal anaesthesia. Fifty-four [54 (52.9%)] had a combined SBx and TURBP (Group 1) and 48 (47.1%) had a SBx only (Group 2).

RESULTS:

The CaP detection rate in Group 1 was 38.9% (21/54), which was significantly higher than the detection rate of 27.1% (13/48) in Group 2 (P = 0.005). CaP was detected via TURBP in 12 patients (22.2%) from Group 1, including 8 (14.8%) patients who had CaP solely in their TURBP chips. According to the D'Amico classification, 66.6% (14/21) of the cancers in Group 1 were intermediate (n = 4) or high risk (n = 10). Of the 8 'TURBP only' cancers, 75% (6/8) were intermediate (n = 2) or high risk (n = 4). Seven of these eight patients went on to have a radical prostatectomy (RP) but only 2 (28.6%) were found to have a pure anterior/transition zone (TZ) tumor. The postoperative urinary retention and emergency admission rates for Groups 1 and 2 were 29.6% (16/54) vs. 16.6% (8/48) (P = 0.095) and 11.1% (6/54) vs. 5.5% (2/48) (n = 0.17). There was no difference in terms of hematuria (P = 0.54), urinary tract infection (UTI) (P = 0.22), or sepsis (P = 0.21), and patients in Group 1 spent an average of 0.5 days longer in hospital (1.9 vs. 1.4; P = 0.008).

CONCLUSIONS:

TURBP in association with SBx increases the detection of clinically important CaP. However, this does have to be balanced against the small increased incidence of urinary retention, emergency re-admission, and longer hospital stay.

• Authors: David R Yates, Gordon C Gregory, Morgan Roupret, Manar M Malki, Mark D Haynes, Freddie C Hamdy, Derek J Rosario
• Journal: Urologic oncology (Urol Oncol) Vol. 31 Issue 5 Pg. 542-8 (Jul 2013) ISSN: 1873-2496 [Electronic] United States
• PMID: 21493112 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Topics

• Aged
• Biopsy, Needle (methods)
• Cohort Studies
• Humans
• Male
• Middle Aged
• Outcome Assessment, Health Care (statistics & numerical data)
• Prostate (pathology, surgery)
• Prostatectomy
• Prostatic Neoplasms (diagnosis, pathology, surgery)
• Reproducibility of Results
• Review Literature as Topic
• Risk Factors
• Sensitivity and Specificity
• Transurethral Resection of Prostate (methods)