Differences in Postoperative Pathological Outcomes between Prostate Cancers Diagnosed at Initial and Repeat Biopsy
강인호, 김윤범, 양승옥, 이정기, 정태영,
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강인호 ( Khang In-Ho )
Veterans Health Service Medical Center Department of Urology
김윤범 ( Kim Yun-Beom )
Veterans Health Service Medical Center Department of Urology
양승옥 ( Yang Seung-Ok )
Veterans Health Service Medical Center Department of Urology
이정기 ( Lee Jeong-Ki )
Veterans Health Service Medical Center Department of Urology
정태영 ( Jung Tae-Young )
Veterans Health Service Medical Center Department of Urology
KMID : 0358320120530080531
Abstract
Purpose: We evaluated the differences in pathological outcomes between prostate cancers (PCas) diagnosed at initial and repeat biopsy.
Materials and Methods: We retrospectively reviewed the medical records of 287 patients who underwent radical retropubic prostatectomy from 2005 to 2010. We investigated preoperative factors, such as age, serum prostate-specific antigen (PSA), prostate volume (PV), digital rectal examination (DRE) results, biopsy schema, clinical stage, and number of prior biopsies, and postoperative pathological outcomes, including specimen volume, percent tumor volume, Gleason score (GS), tumor bilaterality, pathological stage, positive surgical margin (PSM), lymphovascular invasion (LVI), and perineural invasion (PNI). Patients were then classified into two groups by the number of prior biopsies (initial biopsy vs. repeat biopsy). We compared preoperative factors and postoperative pathological outcomes between the two groups.
Results: Of the 287 patients, 246 (85.7%) were diagnosed with cancer at the initial biopsy and 41 (14.3%) at the repeat biopsy. The repeat biopsy group was older (p=0.048), had a larger PV (p=0.009), had a significantly different biopsy schema (p<0.001), and had a lower (<10%) percentage tumor volume (p=0.016). In the multivariate analysis (after adjustment for biopsy schema, age, serum PSA, PV, and DRE), repeat biopsy was not an independent predictor of GS, tumor bilaterality, pathological stage, PSM, LVI, or PNI (p=0.212, 0.456, 0.459, 0.917, 0.991 and 0.827, respectively), but repeat biopsy could predict lower percentage tumor volume (p=0.037).
Conclusions: The pathological outcomes of PCas detected at repeat biopsy were not significantly different from those of PCas detected at initial biopsy except for a lower (<10%) percentage tumor volume.
키워드
Biopsy; Prostatectomy; Prostatic neoplasms; Tumor burden
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