title: Does prior benign prostate biopsy predict outcome for patients treated with radical perineal prostatectomy?
abstract: OBJECTIVE
  To determine the effect of prior benign prostate biopsies on the surgical and clinical outcomes of patients treated with radical perineal prostatectomy for prostate cancer.
  
  
  METHODS
  A total of 1369 patients with clinically localized prostate cancer underwent radical prostatectomy by a single surgeon between 1991 and 2001. A subset of 203 patients (14.9%), who had undergone at least one prior benign prostate biopsy for a rising prostate-specific antigen and/or abnormal digital rectal examination, constituted our study population. A total of 1115 patients with no prior biopsy represented our control group. After prostatectomy, patients were evaluated at 6-month intervals for biochemical evidence of recurrence, defined as a prostate-specific antigen level of 0.5 ng/mL or greater.
  
  
  RESULTS
  Patients with a prior benign biopsy had more favorable pathologic features with more organ-confined (74% versus 64%; P <0.001) and less margin-positive (9.8% versus 18%) disease. Only 24 patients (12%) in the study group (versus 20% in control group; P = 0.01) had eventual evidence of biochemical failure. Kaplan-Meier analyses suggested that patients with prior benign biopsies have improved biochemical disease-free survival, especially for those with more aggressive disease (Gleason sum 7 or greater; P <0.01). Overall, patients in the study group had lower probability (odds ratio 0.57, P <0.001) of biochemical failure compared with those in the control group.
  
  
  CONCLUSIONS
  A prior benign prostate biopsy may be independently associated with more favorable surgical and biochemical outcomes after prostatectomy. Additional studies are needed to confirm these findings.
authors.affiliation: Division of Urology, Duke University Medical Center, Durham, North Carolina 27710, USA.
authors.forename: Ganesh V
authors.initials: GV
authors.lastname: Raj
authors.forename: James H
authors.initials: JH
authors.lastname: Brashears
authors.forename: Ankur
authors.initials: A
authors.lastname: Anand
authors.forename: David F
authors.initials: DF
authors.lastname: Paulson
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Polascik
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy; D015331:Cohort Studies; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000097:blood; D016016:Proportional Hazards Models; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D017430:Prostate-Specific Antigen