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Open Access Highly Accessed Research article

Characterization of prostate cancer detected at repeat biopsy

Takeshi Yuasa, Norihiko Tsuchiya, Teruaki Kumazawa, Takamitsu Inoue, Shintaro Narita, Mitsuru Saito, Yohei Horikawa, Shigeru Satoh and Tomonori Habuchi*

Author Affiliations

Department of Urology, Akita University School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan

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BMC Urology 2008, 8:14  doi:10.1186/1471-2490-8-14

Published: 10 November 2008

Abstract

Background

The aim of this study was to investigate the characteristics of prostate cancer patients who were diagnosed at repeat biopsy and compare them to non-cancerous patients or patients who were diagnosed at initial biopsy.

Methods

We carried out a retrospective analysis of clinical and pathological data from 576 patients, which included data on the period of time from radical prostatectomy to biochemical failure.

Results

Cancer was diagnosed in 191 (33%) of 576 patients at initial biopsy and in 23 (18%) of 127 patients who underwent a repeat biopsy. Cut-off values of 0.80 and 0.30 for prostate specific antigen velocity (PSAV) and prostate specific antigen density (PSAD), respectively, were determined using ROC curve analysis. Based on these values, PSAV and PSAD were able to predict 94% (46 of 49) of negative repeat biopsies, indicating that these patients had undergone unnecessary repeat biopsies. Although the patients who were diagnosed at repeat biopsy had a higher rate of organ-confined tumor than those who were diagnosed at initial biopsy (73% and 44%, respectively; P = 0.041), there were no differences in the recurrence rate or the duration of biochemical failure-free survival between the two groups.

Conclusion

PSAV and PSAD may be useful indicators of the results of repeat biopsies. Although prostate cancer that was diagnosed at repeat biopsy was associated with a more favorable pathological profile, it was not associated with a better outcome after radical prostatectomy.