Integral estimate of the parameters of transrectal multifocal rebiopsy in the diagnosis of prostate cancer

Abstract

Materials and Methods. The results of transrectal multifocal prostatic rebiopsy made under ultrasound guidance at the Clinic of Urology, Military Medical Academy, in 1998 to 2004 were studied.

A total of 2352 males were examined; of them, 125 patients underwent rebiopsy. The patients’ age was 54 to 87 years (mean age 60.3 years). The patients were divided into 4 age groups: 1) 51-60 years [11% (14/125)]; 2) 61-70 years [47% (59/125)]; 3) 71-80 years [35% (44/125)]; 4) > 81 years [0.3% (4/125)]. There were 6 to 14 biopsy probes.

Results. The study showed that rebiopsy of the prostate identified its cancer in 23% of the patients having a negative primary histological result. It was also established that the patients in whom primary biopsy revealed prostatic intraepithelial neoplasia (PIN) and/or an increase in PSA of > 0.75 ng/ml per year and its density > 0.15 ng/ml/cm3 should be referred to a repeated histological study within 6 to 12 months. When these rules were observed, there were the most favorable prognostic signs: no capsular invasion, lower Glisson scores, and none metastasis.

Conclusion. The study has provided the following indications for rebiopsy:

— a continually elevating PSA level or its preservation after primary negative biopsy;

— abnormal findings on rectal examination and transrectal ultrasound study;

— high-grade PIN in the prior biopsy specimen.