EAU Session On Prostate Biopsy 1

Main Category: Prostate / Prostate Cancer
Also Included In: MRI / PET / Ultrasound;  Urology / Nephrology;  Men's health
Article Date: 02 Apr 2007 - 0:00 PDT

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UroToday.com - A poster session on "Prostate Biopsy 1" took place at the EAU on Thursday March 22, 2007. Two posters from this session are covered herein.

Dr. Horninger, Innsbruck reported "Complication Rates of 7,074 Transrectal Ultrasound (TRUS) Guided Biopsies of the Prostate: Results from the Tyrol PSA Screening Project". Participants in the study had sextant biopsies if performed during 1993-1995 and 10 core biopsies between 1995 and 2000. Since 2000 five additional targeted biopsies have been added to the schema. All received prophylactic antibiotics using ciprofloxacin orally starting one day before the procedure. Complications were assessed by a physician in a personal interview or by phone. The 7,074 biopsies were performed in 5,153 men. Minor complications included hematuria >1 day (13.8%), hematospermia (35.8%), and rectal bleeding (2.1%). Major complications were prostatitis, epididymitis, fever >38°C, rectal bleeding >2 days, and urinary retention, all <1.0%. This study validates the safety of TRUS biopsy of the prostate.

Dr. Gosselaar, Rotterdam presented "The Value of an Additional Hypoechogenic Lesion-Directed Biopsy for the Detection of Prostate Cancer". In 10,754 screened men, 1,849 underwent TRUS/Bx and CaP was detected in 541 (29.3%). Of the biopsy group, 445 men (24%) had an additional 7th lesion directed biopsy. In these men, 230 cases of CaP were detected (52%). The 7th biopsy showed CaP in 73%, in contrast to the mean percentage of CaP in the random cores of 47%. Only in 3.5% was the lesion directed core the unique site of CaP detection. Thus only 8 patients had cancer detected based upon the addition of the directed biopsy core. These 8 tumors comprised 40% of the core, 5 of 8 had a Gleason score of 7 or higher and 3 had extracapsular extension of their disease. The authors conclude that although the CaP detected in these 8 men was significant, the overall detection rate of 3.5% as a result of the additional 7th biopsy is small.

Reviewed by UroToday.com Contributing Editor By Christopher P. Evans, M.D., FACS

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