Faculty Collaboration Database

Recutting prostate needle core biopsies with high grade prostatic intraepithelial neoplasia increases detection of adenocarcinoma. Can J Urol 2009 Feb;16(1):4484-9

Date

02/19/2009

Pubmed ID

19222887

Scopus ID

2-s2.0-64749113143 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

OBJECTIVES: We sought to evaluate the ability of biopsy core recutting to increase cancer detection in patients with high grade prostatic intraepithelial neoplasia (HGPIN).

METHODS: This prospective study encompasses all patients undergoing 12 core TRUS guided prostate biopsy between February 2004 and January 2007. In patients with HGPIN on initial biopsy, the paraffin blocks were resampled for cancer by additional deeper levels per core. Additional analysis was performed in the patients with HGPIN in order to detect whether significant differences in prebiopsy variables were associated with patients subsequently found to have benign versus carcinoma on recutting. Last, the costs associated with this procedure were studied.

RESULTS: Forty of 584 (6.8%) patients undergoing prostate biopsy were found to have HGPIN in the absence of prostatic adenocarcinoma on initial histopathology. Following recutting, 12.5% (5/40) of these patients were found to have prostatic adenocarcinoma not previously detected. Of the remaining 35 patients, 18 underwent repeat biopsy. Of these, five patients were found to have adenocarcinoma and three were found to have persistent HGPIN. The PSA, PSA density (PSAD), and PSA velocity (PSAV) prior to initial biopsy were not statistically different when comparing patients found to have benign tissue versus carcinoma on recutting. In patients with HGPIN, at our institution, recutting the biopsy would yield a cost savings of $436/patient as opposed to universal rebiopsy.

CONCLUSIONS: Our data suggest that prostate biopsy recutting may increase cancer detection in patients initially found to have HGPIN. Additionally, a significant cost savings is associated with the recutting protocol.

Author List

Rapp DE, Msezane LP, Reynolds WS, Lotan TL, Obara P, O'Connor RC, Taxy JB, Gerber GS, Zagaja GP

Author

Robert Corey O'Connor MD Professor in the Urologic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adenocarcinoma
Adult
Aged
Aged, 80 and over
Biopsy, Needle
Humans
Male
Middle Aged
Neoplasms, Multiple Primary
Prospective Studies
Prostate
Prostatic Intraepithelial Neoplasia
Prostatic Neoplasms