The Chances of Subsequent Cancer Detection in Patients with a PSA > 20 ng-ml and an Initial Negative BiopsyReport as inadecuate




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TheScientificWorldJOURNAL - Volume 9 2009, Pages 343-348

Research Article Harold Hopkins Department of Urology, Royal Berkshire Foundation NHS Trust, Reading, RG1 5AN, United Kingdom

Received 4 February 2009; Revised 14 May 2009; Accepted 15 May 2009

Academic Editor: Anthony Atala

Copyright © 2009 Nadeem Shaida et al.

Abstract

Transrectal ultrasound TRUS–guided prostate biopsy is known to carry a significant false-negative rate, leading some patients to have multiple biopsies. We investigated cancer detection rates in patients with a PSA >20 ng-ml and a negative initial biopsy. We reviewed our database of 2396 TRUS-guided biopsies done between 1997 and 2002 in order to give a follow-up of at least 6 years. PSA, PSA density PSAD, PSA velocity PSAV, prostate volume, and DRE findings were analysed in relation to cancer status. Of the patients, 388 16% had a PSA >20 ng-ml, including 99 26% with benign biopsies. Of those, 67 were rebiopsied, including 19 28% with cancer on the first rebiopsy and four 6% on further biopsies. PSAD, DRE, and volume significantly differed between rebiopsied patients with and without cancer p <0.05. Patients who present with a PSA >20 ng-ml and have an initial negative biopsy have a high chance of malignancy being detected on a second biopsy. However, if a second biopsy is also negative, then the chances of subsequent biopsies showing signs of cancer are very low if the DRE is normal and particularly if the PSAD is >0.35 ng-ml-cm

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Author: Nadeem Shaida, Catherine M. Jones, Navin Ravindranath, and Peter R. Malone

Source: https://www.hindawi.com/



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