Original Articles: Prostate Cancer: Variable Histology of Anastomotic Biopsies With Detectable Prostate Specific Antigen After Radical Prostatectomy

Fowler, Jackson E.; Brooks, Jay P.; Pandey, Prabhakar; Seaver, Linda E.

doi:10.1016/s0022-5347(01)67624-9

Cited by 66 publications

(26 citation statements)

References 9 publications

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“…Also, the interval between surgery and the time of anastomotic TRUS biopsy (or biochemical failure) was longer in patients with a positive biopsy that in patients with negative biopsy. 33 This remark agrees also with reports from Fowler et al 34 and Partin et al, 35 while Lightner et al 36 have reported differently. Nevertheless, this fact does not rule out the possibility of a positive biopsy in cases with earlier occurrence of biochemical failure, so it is not advisable to avoid anastomotic biopsy due to that fact.…”

Section: Postradical Prostatectomy Trus-guided Anastomotic Biopsy T Asupporting

confidence: 83%

“…Fowler et al 34 have studied a series of 41 men and having obtained 61 biopsy results from these patients, they confirmed a 39% initial biopsy positive rate for adenocarcinoma of the prostate with an overall rate of 59%. Interestingly, they report six cases where only benign prostate tissue was recovered from biopsy specimens.…”

Section: Diagnostic Accuracy: Histological Outcomementioning

confidence: 88%

“…If initial Postradical prostatectomy TRUS-guided anastomotic biopsy T Anagnostou et al biopsy fails to establish local recurrence, one repeat biopsy would successfully diagnose local cancer in another 16-17% of cases. 25,34 Some authors 36 have also evaluated cases with normal PSA levels (o0.3 ng/ml) or lower 33 than 0.5 ng/ml, and reported that no local disease was discovered. These findings support the hypothesis that presence of local recurrence in PSA range below 0.5 ng/ml seems unlikely.…”

Section: Discussionmentioning

confidence: 99%

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Postradical prostatectomy TRUS-guided anastomotic biopsy. Where do we stand today?

Anagnostou

Doumas

Remzi

et al. 2004

Prostate Cancer Prostatic Dis

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The issue of performing tissue sampling from the vesicourethral anastomotic area postradical prostatectomy (transrectal ultrasound-guided biopsy) after radical surgical treatment of local disease has failed, still remains controversial. We review a selection of articles that evaluate this procedure as well as newer diagnostic modalities and we discuss how this technique may have a position in our treatment dilemmas in cases with biochemical failure of undetermined origin.

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Section: Postradical Prostatectomy Trus-guided Anastomotic Biopsy T Asupporting

confidence: 83%

Section: Diagnostic Accuracy: Histological Outcomementioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Postradical prostatectomy TRUS-guided anastomotic biopsy. Where do we stand today?

Anagnostou

Doumas

Remzi

et al. 2004

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

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“…To account for some of the potential bias, we evaluated separately the patients who were sent in for consultation as opposed to those who came to our institution for therapy. Several investigators have demonstrated the difficulty of diagnosing recurrent adenocarcinoma on biopsy, sometimes requiring the patient to have several needle biopsies over time (3)(4)(5). There are conflicting studies in the literature of whether transrectal ultrasound or digital rectal examination has greater sensitivity in detecting local recurrence (3)(4)(5)(6)(7).…”

Section: Discussionmentioning

confidence: 99%

“…Most studies have concentrated on men who had biochemical evidence of progression as the sole indication of failure (1). The few reports that evaluated local recurrence concentrated on clinical issues, including (1) the use of radiotherapy to treat local recurrence (2); (2) the need for several biopsies to document local recurrence (3)(4)(5); (3) the use of ultrasound, serum PSA, and digital rectal examination to detect local recurrence (3)(4)(5)(6)(7); and (4) the sites of local recurrence, including the anastomotic site (66%), bladder neck (16%), retrovesical space (13%), and unknown (5%) (3).…”

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confidence: 99%

Needle Biopsy of Recurrent Adenocarcinoma of the Prostate After Radical Prostatectomy

et al. 2000

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The objective of this study was to evaluate needle biopsy of recurrent prostate cancer after radical prostatectomy. We evaluated 37 cases of recurrent prostate cancer after radical prostatectomy that were diagnosed by needle biopsy between March 1984 and July 1998. Fifteen were from consultations in which contributors were uncertain of the diagnosis, and 22 were from men who had come to The Johns Hopkins Hospital for treatment. The median interval from radical prostatectomy to biopsy showing recurrent tumor was 40 months. There was no correlation between the interval to recurrence and either pathologic features of the biopsy and radical prostatectomy or various clinical features. The mean extent of adenocarcinoma in the biopsies was 3.2 mm (range, 0.1 to 18 mm; median, 2 mm). The length of recurrent cancer on biopsy correlated with an abnormal rectal examination (P ‫؍‬ .001). The mean Gleason score for the recurrent tumors was 6.5, which correlated with the grade of the radical prostatectomy cancer (P ‫؍‬ .005). The cancers often lacked overt histologic features of malignancy. Benign prostatic acini were seen in five cases (14%), usually separate from the cancer. In 5 (33%) of the consultation cases, we would not have been able to diagnose cancer if not for the fact that atypical prostate glands should not be present after radical prostatectomy. In well-sampled radical prostatectomies, margins were almost always positive, as was extraprostatic extension. In cases with less sampling, there was a higher incidence of organ-confined disease and margin-negative disease implying suboptimal processing of the radical prostatectomy. After radical prostatectomy, recurrent cancer on needle biopsies may be focal and difficult to diagnose and must be assessed differently than in patients who have not had surgery.

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Influence of digital rectal massage on urinary prostate-specific antigen: Interest for the detection of local recurrence after radical prostatectomy

et al. 1998

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BACKGROUND Following radical prostatectomy, urinary prostate‐specific antigen (uPSA) may originate from periurethral glands or from recurrent carcinomatous prostatic cells. We evaluated massage of the urethro‐vesical anastomosis as a uPSA‐releasing method for the detection of local recurrence. METHODS PSA was assessed (PSA IMx™, Abbott Diagnostic, Rungis, France) in serum and in the first voided urine before and after massage in 59 patients: 7 after cystoprostatectomy for bladder cancer, 22 with prostate in situ, and 30 after radical prostatectomy for prostate cancer. RESULTS No significant changes of uPSA were induced by the massage in cystoprostatectomy patients and in 4 radical prostatectomy patients with a negative biopsy of the anastomosis. In contrast, a significant increase of uPSA was observed after massage in the patients with prostate in situ and in 6 radical prostatectomy patients with biopsy‐proven local relapse. CONCLUSIONS uPSA before and after massage of the prostatic fossa may constitute a new and efficient tool for the detection of local recurrence, if these preliminary results are confirmed on a larger scale. Prostate 34:23–28, 1998. © 1998 Wiley‐Liss, Inc.

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Original Articles: Prostate Cancer: Variable Histology of Anastomotic Biopsies With Detectable Prostate Specific Antigen After Radical Prostatectomy

Cited by 66 publications

References 9 publications

Postradical prostatectomy TRUS-guided anastomotic biopsy. Where do we stand today?

Postradical prostatectomy TRUS-guided anastomotic biopsy. Where do we stand today?

Needle Biopsy of Recurrent Adenocarcinoma of the Prostate After Radical Prostatectomy

Influence of digital rectal massage on urinary prostate-specific antigen: Interest for the detection of local recurrence after radical prostatectomy

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