Characteristics of prostate cancer detected during primary (systematic) and repeated prostate biopsy and its assessment alter radical prostatectomy

Introduction. When diagnosing prostate cancer (PCa) in 20-40% of patients, more than one prostate biopsy (BP) is required. The incidence of PCa in recurrent BP is 20%. Purpose of the study. To identify the differences in prostate cancer detected in primary and recurrent BP Materials and methods. The study included 44 patients with prostate cancer. Group I consisted of 19 men with PCa detected in recurrent BP (medians: age -60 years, PSA - 9.9 ng / ml, prostate volume - 44.3 cm3, tumor in biopsy - 15%). A lesion in the prostate, according to transrectal ultrasonography (TRUS), was detected in 26% of patients, PIN3 - in 20%, cT1a - in 5.3%, cT1b - in 26.3%, T1c - in 21.0%, cT2 - at 47.4%. Group II included 25 men with prostate cancer detected in primary BP (medians: age - 63 years, PSA - 7.1 ng / ml, prostate volume - 38 cm3, tumor in biopsy - 40%). A lesion in the prostate with TRUS was detected in 68% of patients, PIN 3 - in 20%, stage cT1c - in 76.0%, cT2 - in 24.0%. Radical prostatectomy was performed in 15 patients: 7 in group I and 8 in group II. After morphological studying of removed prostate in group I, stage pT2a was detected in 57.1% of patients, pT2b - in 14.3%, pT2c - in 28.6%, invasion of prostate cancer into the capsule of the gland - in 28.6%. Group ISUP-1 corresponded to 14% of patients, ISUP-2 - 43%, ISUP > 3 - 43%. After evaluation of the drug in group II, stage pT2a was detected in 12.5% of patients, pT2c - in 87.5%, prostate cancer invasion into the glandular capsule - in 9%, ISUP > 3 - in 100%. Results. Comparison of the groups revealed differences in the volume of the tumor in the biopsy specimen (p = 0.005), the criterion for the involvement of the gland capsule in the tumor process (p = 0.007), the proportion of patients with a focus on TRUS (p = 0.01) with the prevalence of these signs in group II. The groups were comparable in pT stage, ISUP and lesion volume in the gland preparation (p> 0.05). Conclusion. The low efficiency of primary PD is due to the shortcomings of its randomness and low accuracy. The absence of PCa in systemic PD is not a sign of a small tumor in the gland. Protate cancer detected during repeated PD is quite aggressive.