title: Importance of TURP in diagnosing prostate cancer in men with multiple negative biopsies.
abstract: OBJECTIVE
  Patients with persistently elevated PSA and multiple negative TRUS guided 12-core biopsies, present a clinical conundrum. We evaluated the efficacy of transurethral biopsy and/or resection in abetting prostate cancer diagnosis.
  
  
  METHODS
  Eleven patients who had prostate cancer diagnosed only on TURP following TRUS guided (24-48 cores) negative biopsies, including five who underwent radical prostatectomy were assessed. Extent and site of tumour was analysed in relation to the TURP cavity.
  
  
  RESULTS
  Mean age was 61.8 years (PSA range: 3.8-20.9 ng/ml.). Patients had TURP for worsening LUTS with chippings diagnosing invasive prostate cancer. Organ confined anterior prostate cancer was diagnosed in five who had radical prostatectomy.
  
  
  CONCLUSIONS
  Anteriorly directed transurethral biopsies and/or TURP help in the diagnosis of prostate cancer in patients with multiple negative biopsies. Patients with anterior prostate cancer tend to have organ-confined disease even with higher PSA.
authors.affiliation: Department of Pathology, Royal Liverpool University Hospital, Liverpool, United Kingdom. indianajoe72@yahoo.com
authors.forename: J
authors.initials: J
authors.lastname: Philip
authors.forename: S
authors.initials: S
authors.lastname: Dutta Roy
authors.forename: J
authors.initials: J
authors.lastname: Scally
authors.forename: C S
authors.initials: CS
authors.lastname: Foster
authors.forename: P
authors.initials: P
authors.lastname: Javlé
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology*; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome
chemical_list: D017430:Prostate-Specific Antigen