title: Value of immediate anastomotic biopsy following biochemical failure after radical prostatectomy.
abstract: OBJECTIVE
  To study the value, in diagnostic terms, of performing transrectal ultrasound (TRUS)-guided anastomotic biopsy immediately following the diagnosis of biochemical failure in patients treated by radical retropubic prostatectomy.
  
  
  METHODS
  We report on 50 sessions of TRUS-guided biopsy obtained during post-radical retropubic prostatectomy follow-up, immediately after the diagnosis of biochemical failure. No patient had received either adjuvant or further treatment due to biochemical failure status prior to the biopsy session. In each case, tissue sampling involved cores taken by a standard protocol (random) as well as TRUS-guided biopsy to sonographically suspicious areas. Statistical analysis focused on identifying the statistical importance of various pre- and post-treatment variables in predicting biopsy outcome.
  
  
  RESULTS
  10/50 cases with local evidence of malignancy (1 case harboring both benign and malignant glands) were identified and in another 10/50 cases benign prostatic tissue was diagnosed. The remaining (30) cases have shown fibromuscular tissue only. Statistical analysis of various parameters has demonstrated a significant correlation between local evidence of cancer and the finding of sonographically remarkable areas.
  
  
  CONCLUSIONS
  Performing TRUS-guided anastomotic biopsy close to the onset of biochemical failure can frequently identify but also may easily miss the suspected local presence of prostate tissue. We believe that, with minimal risks of morbidity, there is merit in exploring its possibilities to trace local prostatic tissue, since it may provide useful information for further treatment actions also in an earlier time.
authors.affiliation: Department of Urology, University of Athens, Athens, Greece. theoan@otenet.gr
authors.forename: Theodore
authors.initials: T
authors.lastname: Anagnostou
authors.forename: Frank
authors.initials: F
authors.lastname: Sofras
authors.forename: Michael D
authors.initials: MD
authors.lastname: Melekos
authors.forename: Demetrios
authors.initials: D
authors.lastname: Pantazopoulos
authors.forename: Michael
authors.initials: M
authors.lastname: Lykourinas
authors.forename: Aristeides
authors.initials: A
authors.lastname: Giannopoulos
authors.forename: Bob
authors.initials: B
authors.lastname: Djavan
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D001706:Biopsy; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000378:metabolism / Q000601:surgery; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods