Urology Unit, Cannizzaro Hospital, Catania, Italy.
To evaluate if an inflammatory pattern at primary biopsy is associated with a lower risk for cancer in men submitted to repeated saturation prostate biopsy (SPBx).
From January 2005 to January 2010, 320 patients, after a negative primary extended biopsy (median 18 cores), underwent SPBx by transperineal approach performing 27 cores (median). 210 (65.6%) patients had a normal parenchyma and 110 had an inflammatory pattern (34.4%) at primary biopsy (none of them complained of symptoms suggesting a diagnosis of acute prostatitis at the time of biopsy). Moreover, median prostate-specific antigen and abnormal digital rectal examination was equal to 7.3 ng/ml and 3.6% versus 8.2 ng/ml and 3.8%, respectively.
Prostate cancer (PCa) was found in 66 (20.5%) of 320 patients. Of these, 42 (63.6%) and 24 (36.4%; p = 0.007) had a histological diagnosis of chronic prostatitis and normal parenchyma at primary biopsy, respectively.
An inflammatory pattern at primary biopsy is not associated with a decrease in PCa incidence at repeated SPBx; therefore, only an accurate clinical evaluation including more parameters (i.e. urinary PCA3) could hopefully select men who need to undergo rebiopsy in the presence of persistent suspicion of cancer.
Written by:
Pepe P, Aragona F. Are you the author?
Reference: Urol Int. 2011 Jul 19. Epub ahead of print.
doi: 10.1159/000328043
PubMed Abstract
PMID: 21778685
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