Diagnostic Role of Prostate Resection in the Elderly Patients Who Experience Significant Co-Morbidity with a High Clinical Suspicion of Prostate Cancer.
10.3346/jkms.2013.28.12.1796
- Author:
Ho Won KANG
1
;
Jin Bak YANG
;
Whi An KWON
;
Young Suk LEE
;
Won Tae KIM
;
Yong June KIM
;
Seok Joong YUN
;
Sang Cheol LEE
;
Isaac Yi KIM
;
Wun Jae KIM
Author Information
1. Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Korea. sjyun@chungbuk.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Prostate Neoplasms;
Transurethral Prostatic Resection of Prostate;
Transrectal Prostate Biopsy;
Prostate-Specific Antigen
- MeSH:
Aged;
Aged, 80 and over;
Area Under Curve;
Biopsy, Needle;
Comorbidity;
Humans;
Male;
Neoplasm Grading;
Prostate/*surgery;
Prostate-Specific Antigen/*blood;
Prostatic Neoplasms/*diagnosis/epidemiology/*pathology/surgery;
ROC Curve;
Transurethral Resection of Prostate
- From:Journal of Korean Medical Science
2013;28(12):1796-1800
- CountryRepublic of Korea
- Language:English
-
Abstract:
The necessity of routine prostate biopsy prior to transurethral resection of the prostate (TURP) in elderly comorbid patients with a high prostate specific antigen (PSA) level remains controversial. We assessed the role of TURP in prostate cancer diagnosis in these individuals. A total of 197 patients underwent TURP in conjunction with prostatic needle biopsy. Pathologic reviews of specimens of TUR chips and biopsy cores were analyzed. Overall, prostate cancer (CaP) was detected in 114 patients (57.6%). Ninety-eight cancers (86%) were detected with TURP and biopsy, and seven cancers (6.1%) with only TURP. The Gleason score of a TUR-specimen was identical to that of the biopsy-core in 43.9% of cases. Variables associated with diagnostic accuracy in the TUR-specimens included the prebiopsy PSA level, prostate specific antigen density (PSAD), and the Gleason score in biopsy cores. In patients with a PSA level and a PSAD that was greater than 15.4 ng/mL and 0.69 ng/mL/g, respectively, 100% of the cancers were detected in the TUR-specimens. Our results suggest that a prostatic biopsy might be omitted prior to TURP in elderly patients with significant co-morbidity and levels for PSA of >15.4 ng/mL.
