title: Diagnostic role of prostate resection in the elderly patients who experience significant co-morbidity with a high clinical suspicion of prostate cancer.
abstract: The necessity of routine prostate biopsy prior to transurethral resection of the prostate (TURP) in elderly comorbid patients with a high prostate specific antigen (PSA) level remains controversial. We assessed the role of TURP in prostate cancer diagnosis in these individuals. A total of 197 patients underwent TURP in conjunction with prostatic needle biopsy. Pathologic reviews of specimens of TUR chips and biopsy cores were analyzed. Overall, prostate cancer (CaP) was detected in 114 patients (57.6%). Ninety-eight cancers (86%) were detected with TURP and biopsy, and seven cancers (6.1%) with only TURP. The Gleason score of a TUR-specimen was identical to that of the biopsy-core in 43.9% of cases. Variables associated with diagnostic accuracy in the TUR-specimens included the prebiopsy PSA level, prostate specific antigen density (PSAD), and the Gleason score in biopsy cores. In patients with a PSA level and a PSAD that was greater than 15.4 ng/mL and 0.69 ng/mL/g, respectively, 100% of the cancers were detected in the TUR-specimens. Our results suggest that a prostatic biopsy might be omitted prior to TURP in elderly patients with significant co-morbidity and levels for PSA of >15.4 ng/mL.
authors: Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Korea.
authors: Ho Won
authors: HW
authors: Kang
authors: Jin Bak
authors: JB
authors: Yang
authors: Whi-An
authors: WA
authors: Kwon
authors: Young-Suk
authors: YS
authors: Lee
authors: Won Tae
authors: WT
authors: Kim
authors: Yong-June
authors: YJ
authors: Kim
authors: Seok-Joong
authors: SJ
authors: Yun
authors: Sang-Cheol
authors: SC
authors: Lee
authors: Isaac Yi
authors: IY
authors: Kim
authors: Wun-Jae
authors: WJ
authors: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001707:Biopsy, Needle; D015897:Comorbidity; D006801:Humans; D008297:Male; D060787:Neoplasm Grading; D011467:Prostate / Q000601:surgery*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D012372:ROC Curve; D020728:Transurethral Resection of Prostate
chemical_list: D017430:Prostate-Specific Antigen
keywords: Prostate Neoplasms; Prostate-Specific Antigen; Transrectal Prostate Biopsy; Transurethral Prostatic Resection of Prostate