Prevalence and predictors of a positive repeat transrectal ultrasound guided needle biopsy of the prostate Journal Article

  


Authors: Fleshner, N. E.; O'Sullivan, M.; Fair, W. R.
Article Title: Prevalence and predictors of a positive repeat transrectal ultrasound guided needle biopsy of the prostate
Abstract: Purpose: We determined the prevalence of and risk factors for carcinoma in patients with 1 previously negative prostate biopsy. Materials and Methods: Transrectal ultrasound guided prostate needle biopsies were repeated in 130 men. Risk factors analyzed included age, pathological result of initial biopsy, inter-biopsy interval, prostate specific antigen (PSA), PSA density, PSA velocity, digital rectal examination, abnormal transrectal ultrasound and family history of prostate cancer. Results: A total of 39 patients (30%) had positive biopsies for cancer. Univariate analysis revealed that PSA more than 20 ng./ml. and abnormal transrectal ultrasound were more frequent in men with positive second biopsies. Using multivariate logistic regression analysis only PSA more than 20 ng./ml. was a significant risk factor (adjusted odds ratio 4.48, 95% confidence interval 1.02 to 20.1). We determined the incidence of carcinoma in patients who represent the lowest risk group as defined by PSA less than 10 ng./ml., PSA density less than 0.15 mg./ml./cm.3, PSA velocity less than 0.75, ng./ml. per year, no prostatic intraepithelial neoplasia plus negative transrectal ultrasound, digital rectal examination and family history. Of 21 patients who fit this cohort 5 (23.8%) had carcinoma on repeat biopsy. Conclusions: A significant false- negative rate for initial transrectal ultrasound guided prostate biopsies exists. Baseline risk in lowest risk patients is sufficiently high such that one cannot define a subset of patients for whom repeat biopsy is unnecessary. We recommend repeat biopsy in all patients who meet the criteria for a transrectal ultrasound guided biopsy and in whom the initial biopsy is negative.
Keywords: clinical article; middle aged; cancer risk; prostate specific antigen; prevalence; risk factors; risk factor; biopsy; age; risk assessment; prostatic neoplasms; biopsy, needle; prostate biopsy; predictive value of tests; transrectal ultrasonography; ultrasonography; prostate carcinoma; humans; human; male; priority journal; article
Journal Title: Journal of Urology
Volume: 158
Issue: 2
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 1997-08-01
Start Page: 505
End Page: 509
Language: English
DOI: 10.1016/s0022-5347(01)64518-x
PUBMED: 9224334
PROVIDER: scopus
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-0030807955&doi=10.1016%2fS0022-5347%2801%2964518-X&partnerID=40&md5=55c7a09bf16f4141a2417531217047e5
Notes: Article -- Export Date: 17 March 2017 -- Source: Scopus
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MSK Authors
  1. William R Fair
    342 Fair
  2. Maryellen O'Sullivan
    16 O'Sullivan
  3. Neil E. Fleshner
    14 Fleshner
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