Prostate cancer rates in patients with initially negative elastography-targeted biopsy vs. systematic biopsy
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To assess whether real-time elastography-targeted biopsy (RTE-bx) is superior to the standard systematic transrectal ultrasound (TRUS)-guided biopsy in predicting subsequent prostate cancer (PCa) rates in patients with initially negative biopsy and to specifically reveal differences in the occurrence of high-grade (Gleason ≥ 4 + 3) PCa by comparing both biopsy methods.
Patients and methods
Overall, 630 patients had an initially negative prostate biopsy between 2007 and 2015, either RTE targeted (n = 213) or systematically (n = 417). Follow-up data, ascertained by a questionnaire, of patients receiving RTE-bx were compared to data of patients receiving systematic biopsy (sbx) using Mann–Whitney-U test and Chi-square test. We performed logistic regression analyses to assess any association with PCa or high-grade PCa occurrence.
In total, 258 (41%) patients were diagnosed with PCa at repeat biopsy whereof 54 (8.6%) harboured high-grade PCa. PCa occurred in 95 (44.6%) patients with initially negative RTE-bx and in 163 (39.1%) patients with initially negative sbx (p = 0.003). 24 (11.3%) patients receiving RTE-bx and 30 (7.2%) patients receiving sbx were diagnosed with high-grade PCa (p = 0.095). Logistic regression analyses showed that patients with the initial RTE-bx vs. those with the initial sbx neither resulted in a significant higher risk for PCa occurrence (OR 1.35 [CI 0.87–2.1]; p = 0.2) nor for high-grade PCa occurrence (OR 1.52 [CI 0.66–3.35]; p = 0.3).
We found no statistically significant association of prior biopsy method to subsequent PCa or high-grade PCa occurrence. Referring to our analyses, RTE is not superior to sbx in predicting subsequent PCa rates and, therefore, not eligible to decide on repeat biopsy.
KeywordsProstate biopsy Targeted biopsy Oncological outcome Negative biopsy
Protocol/project development: KB, JK, GS, and PD. Data collection or management: GS and PT. Data analysis: KB, PT, and JK. Manuscript writing/editing: JK, KB, GS, AH, MG, and DT.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The study was approved by the local ethics board, and all subjects provided written informed consent.
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