Recutting prostate needle core biopsies with high grade prostatic intraepithelial neoplasia increases detection of adenocarcinoma.

David E. Rapp, Lambda P. Msezane, W. Stuart Reynolds, Tamara L. Lotan, Piotr Obara, R. Corey O'Connor, Jerome B. Taxy, Glenn S. Gerber, Gregory P. Zagaja

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: We sought to evaluate the ability of biopsy core recutting to increase cancer detection in patients with high grade prostatic intraepithelial neoplasia (HGPIN). METHODS: This prospective study encompasses all patients undergoing 12 core TRUS guided prostate biopsy between February 2004 and January 2007. In patients with HGPIN on initial biopsy, the paraffin blocks were resampled for cancer by additional deeper levels per core. Additional analysis was performed in the patients with HGPIN in order to detect whether significant differences in prebiopsy variables were associated with patients subsequently found to have benign versus carcinoma on recutting. Last, the costs associated with this procedure were studied. RESULTS: Forty of 584 (6.8%) patients undergoing prostate biopsy were found to have HGPIN in the absence of prostatic adenocarcinoma on initial histopathology. Following recutting, 12.5% (5/40) of these patients were found to have prostatic adenocarcinoma not previously detected. Of the remaining 35 patients, 18 underwent repeat biopsy. Of these, five patients were found to have adenocarcinoma and three were found to have persistent HGPIN. The PSA, PSA density (PSAD), and PSA velocity (PSAV) prior to initial biopsy were not statistically different when comparing patients found to have benign tissue versus carcinoma on recutting. In patients with HGPIN, at our institution, recutting the biopsy would yield a cost savings of $436/patient as opposed to universal rebiopsy. CONCLUSIONS: Our data suggest that prostate biopsy recutting may increase cancer detection in patients initially found to have HGPIN. Additionally, a significant cost savings is associated with the recutting protocol.

Original languageEnglish (US)
Pages (from-to)4484-4489
Number of pages6
JournalThe Canadian journal of urology
Volume16
Issue number1
StatePublished - Feb 2009
Externally publishedYes

ASJC Scopus subject areas

  • Urology

Fingerprint Dive into the research topics of 'Recutting prostate needle core biopsies with high grade prostatic intraepithelial neoplasia increases detection of adenocarcinoma.'. Together they form a unique fingerprint.

  • Cite this

    Rapp, D. E., Msezane, L. P., Reynolds, W. S., Lotan, T. L., Obara, P., O'Connor, R. C., Taxy, J. B., Gerber, G. S., & Zagaja, G. P. (2009). Recutting prostate needle core biopsies with high grade prostatic intraepithelial neoplasia increases detection of adenocarcinoma. The Canadian journal of urology, 16(1), 4484-4489.