Abstract
Purpose
To assess whether real-time elastography-targeted biopsy (RTE-bx) is superior to the standard systematic transrectal ultrasound (TRUS)-guided biopsy in predicting subsequent prostate cancer (PCa) rates in patients with initially negative biopsy and to specifically reveal differences in the occurrence of high-grade (Gleason ≥ 4 + 3) PCa by comparing both biopsy methods.
Patients and methods
Overall, 630 patients had an initially negative prostate biopsy between 2007 and 2015, either RTE targeted (n = 213) or systematically (n = 417). Follow-up data, ascertained by a questionnaire, of patients receiving RTE-bx were compared to data of patients receiving systematic biopsy (sbx) using Mann–Whitney-U test and Chi-square test. We performed logistic regression analyses to assess any association with PCa or high-grade PCa occurrence.
Results
In total, 258 (41%) patients were diagnosed with PCa at repeat biopsy whereof 54 (8.6%) harboured high-grade PCa. PCa occurred in 95 (44.6%) patients with initially negative RTE-bx and in 163 (39.1%) patients with initially negative sbx (p = 0.003). 24 (11.3%) patients receiving RTE-bx and 30 (7.2%) patients receiving sbx were diagnosed with high-grade PCa (p = 0.095). Logistic regression analyses showed that patients with the initial RTE-bx vs. those with the initial sbx neither resulted in a significant higher risk for PCa occurrence (OR 1.35 [CI 0.87–2.1]; p = 0.2) nor for high-grade PCa occurrence (OR 1.52 [CI 0.66–3.35]; p = 0.3).
Conclusions
We found no statistically significant association of prior biopsy method to subsequent PCa or high-grade PCa occurrence. Referring to our analyses, RTE is not superior to sbx in predicting subsequent PCa rates and, therefore, not eligible to decide on repeat biopsy.
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Protocol/project development: KB, JK, GS, and PD. Data collection or management: GS and PT. Data analysis: KB, PT, and JK. Manuscript writing/editing: JK, KB, GS, AH, MG, and DT.
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The study was approved by the local ethics board, and all subjects provided written informed consent.
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Kratzenberg, J., Salomon, G., Tennstedt, P. et al. Prostate cancer rates in patients with initially negative elastography-targeted biopsy vs. systematic biopsy. World J Urol 36, 623–628 (2018). https://doi.org/10.1007/s00345-018-2178-x
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DOI: https://doi.org/10.1007/s00345-018-2178-x