Korean J Urol.  2014 Apr;55(4):249-253. 10.4111/kju.2014.55.4.249.

Efficacy of Repeated Transrectal Prostate Biopsy in Men Younger Than 50 Years With an Elevated Prostate-Specific Antigen Concentration (>3.0 ng/mL): Risks and Benefits Based on Biopsy Results and Follow-up Status

• Park HG
• Ko OS
• Kim YG
• Park JK

• KMID: 1885605
• DOI: http://doi.org/10.4111/kju.2014.55.4.249

Abstract

PURPOSE
Prostate cancer is rare in men younger than 50 years. Digital rectal examination (DRE) and measurement of prostate-specific antigen (PSA) concentrations are standard screening methods for detecting prostate cancer. We retrospectively investigated the risks and benefits of repeated transrectal ultrasonography-guided prostate needle biopsies in relation to the follow-up status of men younger than 50 years with a consistently high PSA concentration (>3.0 ng/mL).
MATERIALS AND METHODS
During the period from January 2000 through February 2013, we reviewed patient's ages, dates of procedures, DRE results, frequencies of biopsies, results of the biopsies, periods of follow-up, PSA concentrations, and prostate volumes in Chonbuk National University Hospital records. We conducted telephone interviews in patients who did not undergo regular follow-up.
RESULTS
The mean age of the patients was 44.7 years, and the mean PSA concentration was 8.59 ng/mL (range, 3.04-131 ng/mL) before biopsy. The PSA concentration was significantly different (p<0.001) between the patients with prostate cancer and those with benign prostatic hyperplasia (BPH). Nineteen patients underwent repeated prostate biopsy; however, in only one patient did the pathologic findings indicate a change from BPH to prostate cancer. We identified several complications after transrectal biopsy through an evaluation of follow-up data.
CONCLUSIONS
All patients with benign prostatic disease based on their first biopsy were shown to have benign disease based on all repeated biopsies (15.83%), except for one patient; however, several complications were noted after biopsy. Therefore, the risks and benefits of repeated biopsy in young patients should be considered because of the low rate of change from benign to malignant disease despite continuously high PSA concentrations (>3.0 ng/mL).

Keyword

Biopsy; Follow-up studies; Prostate; Prostate-specific antigen; Young adult

MeSH Terms

Biopsy*
Biopsy, Needle
Digital Rectal Examination
Follow-Up Studies*
Hospital Records
Humans
Interviews as Topic
Jeollabuk-do
Male
Mass Screening
Prostate*
Prostate-Specific Antigen*
Prostatic Diseases
Prostatic Hyperplasia
Prostatic Neoplasms
Retrospective Studies
Risk Assessment*
Young Adult
Prostate-Specific Antigen

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