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

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• 作者：David R. Yates ; Gordon C. Gregory ; Morgan Roupret ; Manar M. Malki ; Mark D. Haynes ; Freddie C. Hamdy ; Derek J. Rosario
• 关键词：Prostate cancer ; Saturation biopsy ; TURP
• 刊名：Urologic Oncology: Seminars and Original Investigations
• 出版年：2013
• 出版时间：July, 2013
• 年：2013
• 卷：31
• 期：5
• 页码：542-548
• 全文大小：192 K

文摘

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.