UroToday- According to a report in the early view section of the Journal of Urology by Dr. Shah and CaPSURE investigators, increasing number of prostate biopsy cores may have contributed indirectly to improved outcomes after radical prostatectomy in the last decade.

CaPSURE is a longitudinal, observational registry of men with biopsy proven prostate cancer. Between 1995 and 2004, 6,450 men from this registry were included in this analysis of patterns of prostate biopsy and outcome following radical prostatectomy (RP). The mean number of biopsy cores removed was 9.1 and the mean number of positive biopsy cores was 2.9. The mean percent of cores involved with cancer was 33.3%.

The mean number of cores removed increased from 6.9 in 1995 to 10.2 in 2004. However, the number of positive biopsy cores remained unchanged from 2.9 in 1995 to 3.2 in 2004 (not statistically significant). At a median postoperative followup of 2.6 years, 214 of the 1,757 men undergoing RP (12%) had a recurrence; identified as a biochemical recurrence in 162 (76%) and administration of a secondary therapy in 52 (24%). In the proportional hazards model, none of the interactions of biopsy parameter x diagnosis proved to be statistically significant. Repeat analysis without these terms indicated that the number of cores removed did not have a direct effect on recurrence free survival. The number and percent of positive cores predicted disease recurrence after RP. The authors' postulate the increase in the number of cores removed may have led to a biopsy core induced downward migration in risk and consequently an improvement in recurrence free survival after RP over the last decade.

Shah JB, McKiernan JM, Elkin EP, Carroll PR, Meng MV, CaPSURE Investigators

J Urol; 179(1): 136-140, January 2008
DOI: 10.1016/j.juro.2007.08.126

Reported by UroToday Christopher P. Evans, M.D

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