OBJECTIVE: To examine mortality and morbidity following prostate biopsy in the intervention arm of the Prostate, Lung, Colorectal and Ovarian (PLCO) trial.
SUBJECTS AND METHODS: PLCO abstractors recorded the types and dates of diagnostic follow-up procedures following positive screens and documented the types and dates of resultant complications. PLCO tracked participant cancers and deaths. The mortality rate in the 120-day period following prostate biopsy was compared to a control rate of deaths in the 120-day period following a negative screen in men without biopsy. Multivariate analysis was performed to control for potential confounders, including age, comorbidities and smoking. Rates of any, infectious and non-infectious complications were computed among men with negative biopsy; multivariate analysis examined risk factors for complications.
RESULTS: Of 37,345 men enrolled in PLCO (intervention arm), 4861 had at least one biopsy following a positive screen and 28661 had a negative screen and no biopsy. The 120-day post-biopsy mortality rate was 0.95 (per 1,000), compared to the control group rate of 1.8; the multivariate RR was 0.49 (95% CI:0.2-1.1). Among 3706 negative biopsies, rates (per 1,000) of any, infectious and non-infections complications were 20.2, 7.8 and 13.0, respectively. History of prostate enlargement or inflammation was significantly associated with increased rates of both infectious (OR=3.7) and non-infectious (OR=2.2) complications. Blacks had a higher infectious complications rate (OR=7.1); repeat biopsy was associated with lower rates of non-infectious complications (OR=0.3).
CONCLUSION: There was no increased mortality following prostate biopsy in PLCO. Complications were relatively infrequent, with several risk factors identified.
Written by:
Pinsky PF, Parnes HL, Andriole G. Are you the author?
Division of Cancer Prevention, NCI.
Reference: BJU Int. 2013 Jul 19. Epub ahead of print.
doi: 10.1111/bju.12368
PubMed Abstract
PMID: 24053621
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