Use of Age and Medical Comorbidity to Assess Long-term Other-cause Mortality Risk in a Cohort of Men Undergoing Prostate Biopsy at an Academic Medical Center.

Autor: Kominsky HD; Lewis Katz School of Medicine, Temple University, Philadelphia, PA., Bashline M; Lewis Katz School of Medicine, Temple University, Philadelphia, PA., Eun D; Department of Urology, Temple University Hospital, Philadelphia, PA., Pontari MA; Department of Urology, Temple University Hospital, Philadelphia, PA., Mydlo JH; Department of Urology, Temple University Hospital, Philadelphia, PA., Reese AC; Department of Urology, Temple University Hospital, Philadelphia, PA. Electronic address: adam.reese@tuhs.temple.edu.
Jazyk: angličtina
Zdroj: Urology [Urology] 2017 Feb; Vol. 100, pp. 169-174. Date of Electronic Publication: 2016 Sep 14.
DOI: 10.1016/j.urology.2016.09.006
Abstrakt: Objective: To assess life expectancy and biopsy outcomes in men undergoing prostate biopsy at an academic medical center.
Methods: We analyzed men who underwent prostate biopsy at our medical center between July 2012 and June 2014. Long-term other-cause mortality risk was determined using survival tables. Indications for biopsy and biopsy outcomes were assessed, and compared among men with varying mortality risks.
Results: A total of 417 men underwent prostate biopsy, in whom 14-year other-cause mortality risk ranged from 9% to 74%. One hundred ninety-three men (46.3%) were considered low-mortality risk (<40% risk of 14-year mortality), 131 (31.4%) intermediate risk (41%-55% 14-year mortality), and 93 (22.3%) high risk (>55% 14-year mortality). Of the 417 patients who underwent biopsy, 149 (35.7%) were found to have prostate cancer. There was no significant difference in the rate of positive biopsies (P = .72), distribution of Gleason scores (P = .60), or percentage of positive biopsy cores (P = .74) between mortality risk groups. However, by UCSF Cancer of the Prostate Risk Assessment score, there was significant trend toward higher-risk prostate cancer in men with intermediate and high-mortality risk (P = .04).
Conclusion: In this analysis, a large number of men with limited life expectancies underwent prostate biopsy. The majority of these men had negative biopsies or low-risk cancers, suggesting that they were unlikely to benefit from biopsy. To avoid potentially unnecessary prostate biopsies, the practitioner must give serious consideration to a patient's age and medical comorbidities before making a recommendation as to whether biopsy should be performed.
(Copyright © 2016 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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