Japanese Journal of Clinical Oncology, Vol 28, Issue 11 666-672, Copyright © 1998 by Foundation for Promotion of Cancer Research
S Egawa, K Matsumoto, K Yoshida, M Iwamura, S Kuwao and K Koshiba
BACKGROUND: We review the outcomes of ultrasound-guided biopsy in
consecutive patients and assess clinical significance of Japanese prostate
cancer. METHODS: Examination was made of 1469 patients subsequent to
transrectal ultrasound-guided biopsy of the prostate gland. For 84
patients, two or more sets of ultrasound-guided biopsies were conducted
following the initial negative results during this period. Two hundred and
thirty-two patients with benign histology at the initial biopsy underwent
transurethral resection of the prostate (TURP). The clinical significance
of the cancers was assessed based on patient age and calculated tumor
volume at diagnosis, assumed cancer volume doubling time and
life-expectancy in the Japanese male population. RESULTS: Overall, 327 of
the 1469 patients (22.3%) had prostate carcinoma. Positive biopsy rates in
patients with PSA 2.0 ng/ml or lower, 2.1-4.0 ng/ml, 4.1-10.0 ng/ml and
10.1 ng/ml or greater were 4.6%, 8.6%, 15.8% and 59.5%, respectively. Of
the 232 patients who underwent TURP, 15 (6.5%) had cancer. Of the 84
patients subjected to the multiple sets of biopsies, 19 (22.6%) cancers
were detected. Of the 203 cancers without distant metastasis at initial
biopsy, 13.3%, 25.1%, 32.5% and 40.4% of tumors for 2-, 3-, 4- and 6-year
tumor doubling times gave no indication of clinical significance. Nearly
half these patients (43-52%) had clinical stage T1c disease. The estimated
proportion of clinically insignificant tumors in repeat biopsy was
virtually the same as first set biopsies. CONCLUSIONS: Low PSA was not
necessarily an indication of indolent cancer and repeat biopsy did not
often demonstrate clinically unimportant cancers. Many patients with stage
T1c disease may eventually prove to require no treatment.
ORIGINAL ARTICLE
Results of transrectal ultrasound-guided biopsies and clinical significance of Japanese prostate cancer
Department of Urology, Kitasato University School of Medicine, Kanagawa, Japan. s-egpro@sa2.so-net.or.jp
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