Patients with favorable-risk prostate cancer on active surveillance (AS) are strictly followed for safer execution. Repeat protocol biopsy is essential for evaluating cancer aggressiveness. However, the acceptance rate of repeat biopsy is not high enough because of the burdens of biopsy.
We assessed the impact of complications after the initial biopsy on repeat protocol biopsy at 1 year using data from the Prostate Cancer Research International: Active Surveillance (PRIAS)-JAPAN study.
We performed a retrospective analysis using a prospective cohort in the PRIAS-JAPAN study. Patients with favorable-risk prostate cancer (n = 856) who consented to participate in the PRIAS-JAPAN study from 2010 to 2018 were enrolled. Follow-up evaluations included regular prostate-specific antigen, digital rectal examination and biopsy. Rates of complications after biopsies and repeat protocol biopsy non-acceptance rate at 1 year were reported. Logistic regression analysis explored the association between the complications after the initial biopsy and repeat protocol biopsy non-acceptance.
Altogether, 759 patients (88.7%) actually proceeded to protocol at 1 year. Repeat protocol biopsy non-acceptance rate at 1 year was 14.9%. Regarding complications after the initial biopsy, hematuria (p = 0.028) and pain (p < 0.001) rates were significantly higher in the repeat biopsy non-acceptance group, but infection (p = 0.056) and hematospermia (p = 0.337) rates were not different. On multivariate logistic regression analysis, pain was a significant predictor for repeat protocol biopsy non-acceptance (odds ratio 4.68, 95% confidence interval 1.864-11.75; p = 0.001).
Pain at the initial biopsy negatively impacts patients' compliance with further protocol biopsies during AS.
International journal of clinical oncology. 2020 Aug 08 [Epub ahead of print]
Yoichiro Tohi, Takuma Kato, Ryuji Matsumoto, Nobuo Shinohara, Kenichiro Shiga, Akira Yokomizo, Masaki Nakamura, Haruki Kume, Koji Mitsuzuka, Hiroshi Sasaki, Shin Egawa, Masafumi Matsumura, Katsuyoshi Hashine, Junichi Inokuchi, Masatoshi Eto, Haruki Baba, Tomohiko Ichikawa, Hidefumi Kinoshita, Tadashi Matsuda, Yoshiyuki Kakehi, Mikio Sugimoto
Department of Urology, Faculty of Medicine, Kagawa University, 1750-1, Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan. ., Department of Urology, Faculty of Medicine, Kagawa University, 1750-1, Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan., Department of Renal and Genito-Urinary Surgery, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan., Division of Urology, Harasanshin Hospital, Fukuoka, Japan., Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Department of Urology, Tohoku University Graduate School of Medicine, Miyagi, Japan., Department of Urology, Jikei University School of Medicine, Tokyo, Japan., Department of Urology, Shikoku Cancer Center, Ehime, Japan., Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan., Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan., Department of Urology and Andrology, General Medical Center, Kansai Medical University, Osaka, Japan.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/32770439