Prostate cancer diagnosed after repeat biopsies have a favorable pathological outcome but similar recurrence rate Journal Article


Authors: Lopez-Corona, E.; Ohori, M.; Wheeler, T. M.; Reuter, V. E.; Scardino, P. T.; Kattan, M. W.; Eastham, J. A.
Article Title: Prostate cancer diagnosed after repeat biopsies have a favorable pathological outcome but similar recurrence rate
Abstract: Purpose: We investigated whether repeat prostate biopsies are associated with more favorable prognoses, less extensive disease or higher rates of IC in patients who are ultimately diagnosed with prostate cancer and treated with RRP. Materials and Methods: We examined standard clinical and pathological data on 1,357 patients treated with RRP from 1983 to 2001. In addition, we noted the rate of IC in a subgroup of 847 patients in whom tumor volume was measured. Results: Cancer was found in 1,042 patients (77%) at the first biopsy, in 227 (17%) at the second biopsy, in 59 (4%) at the third biopsy and in 29 (2%) at the fourth or later biopsy. Patients with 2 or greater biopsies had a higher rate of clinical T1c stage cancer and larger prostates than patients with only 1 biopsy (each p <0.0001). After RRP patients with 1 biopsy had a lower rate of organ confined tumors (61% vs 75%, p <0.0001), and a higher rate of extracapsular extension, seminal vesicle invasion, lymph node metastases and Gleason sum 7 or greater than other patients. IC was found in 10% of patients with 1 biopsy and 18% of those with 2 or greater biopsies (p = 0.018). Despite these more favorable pathological outcomes there was no difference in biochemical recurrence rate. Conclusions: Although we found that a greater number of biopsies was related to a better pathological outcome after RRP, the number of biopsies did not predict disease recurrence. The increasing number of biopsies currently being performed, especially in patients with larger prostates, likely results in higher rates of IC. Copyright © 2006 by American Urological Association.
Keywords: adult; controlled study; human tissue; aged; aged, 80 and over; middle aged; major clinical study; cancer recurrence; cancer staging; lymph node metastasis; prospective studies; chemical analysis; prostate specific antigen; neoplasm recurrence, local; tumor volume; biopsy; prostate cancer; gleason score; prostatic neoplasms; prostate; prostatectomy; prostate biopsy; seminal vesicle; radical retropubic prostatectomy
Journal Title: Journal of Urology
Volume: 175
Issue: 3
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2006-03-01
Start Page: 923
End Page: 927
Language: English
DOI: 10.1016/s0022-5347(05)00350-2
PUBMED: 16469581
PROVIDER: scopus
PMCID: PMC1951512
DOI/URL:
Notes: --- - "Cited By (since 1996): 10" - "Export Date: 4 June 2012" - "CODEN: JOURA" - "Source: Scopus"
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MSK Authors
  1. Peter T Scardino
    671 Scardino
  2. Makoto Ohori
    50 Ohori
  3. James Eastham
    539 Eastham
  4. Victor Reuter
    1228 Reuter
  5. Michael W Kattan
    218 Kattan