PD44-08 ABNORMAL DIGITAL RECTAL EXAMINATION (DRE) OF THE PROSTATE INCREASES THE LIKELIHOOD OF FUTURE HIGH GRADE PROSTATE CANCER DIAGNOSIS IN PATIENTS WITH INITIAL BENIGN PROSTATE BIOPSY

You have accessJournal of UrologyProstate Cancer: Detection and Screening IV1 Apr 2015PD44-08 ABNORMAL DIGITAL RECTAL EXAMINATION (DRE) OF THE PROSTATE INCREASES THE LIKELIHOOD OF FUTURE HIGH GRADE PROSTATE CANCER DIAGNOSIS IN PATIENTS WITH INITIAL BENIGN PROSTATE BIOPSY Marios Hadjipavlou, Ahmed Mohamed, Sri Sriprasad, Sanjeev Madaan, Shahid Khan, and Abhay Rane Marios HadjipavlouMarios Hadjipavlou More articles by this author , Ahmed MohamedAhmed Mohamed More articles by this author , Sri SriprasadSri Sriprasad More articles by this author , Sanjeev MadaanSanjeev Madaan More articles by this author , Shahid KhanShahid Khan More articles by this author , and Abhay RaneAbhay Rane More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2554AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Digital rectal examination (DRE) of the prostate plays an important role of the workup for patients with suspected prostate cancer but is often thought to be unreliable. METHODS We compared the pre-biopsy DRE finding with the biopsy result in patients with benign histology on initial transrectal ultrasound (TRUS)-guided prostate biopsy who subsequently underwent a TRUS-guided prostate re-biopsy between 2005 and 2012. Patients with known prostate cancer were excluded. RESULTS Overall 2,188 patients underwent a TRUS-guided prostate biopsy. 228 (10.4%) patients with no malignancy detected on initial biopsy underwent re-biopsy, 11 of which subsequently had a third biopsy. No malignancy was detected on repeat biopsy in 73.3% of patients with normal DRE while low- (Gleason≤6), intermediate- (Gleason=7) and high-grade (Gleason≥8) prostate cancer was found in 6.9%, 14.4% and 5.4% of patients respectively. On the other hand, no malignancy was found in 57.7% of patients with abnormal DRE but low-, intermediate- and high-grade prostate cancer was found in 7.7%, 11.5% and 23.1% of patients respectively. The difference was significant for the high risk group (p=0.001). DRE was highly specific at predicting future prostate cancer in patients with no cancer on initial biopsy (90.8%; 95%CI 85.3-94.8%) but was poorly sensitive (16.9%; 95%CI 8.8-28.3%) CONCLUSIONS Our findings suggest that patients with abnormal DRE have a significant chance of future high-grade prostate cancer diagnosis despite normal initial TRUS-guided prostate biopsy. We recommend that patients with abnormal DRE and negative TRUS-guided biopsy are further evaluated immediately with MR imaging or template biopsy as PSA surveillance could delay cancer diagnosis and treatment. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e900 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marios Hadjipavlou More articles by this author Ahmed Mohamed More articles by this author Sri Sriprasad More articles by this author Sanjeev Madaan More articles by this author Shahid Khan More articles by this author Abhay Rane More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...