Login to Access Video or Poster Abstract: MP91-17
Sources of Funding: none

Introduction

As today many men undergo multiple prostate biopsies before undergoing treatment for prostate cancer, the impact of biopsy on functional outcomes after radical prostatectomy (RP) has been questioned. We compared functional outcomes between patients who underwent a single biopsy versus repeat biopsies prior to RP for localized prostate cancer.

Methods

1015 consecutive patients underwent RP and pelvic lymph node dissection from January 1996 to April 2015. Continence and potency were assessed at 3, 6, 12 and 24 months. For evaluation of potency, patients who reported absence of erection sufficient for penetration prior to RP and those who did not receive some form of nerve-sparing were excluded. The Chi-square test and the Mann-Whitney U test were used to compare categorical and continuous variables between patients who underwent a single biopsy versus repeat biopsies prior to RP. Multivariable logistic regression models tested whether repeat biopsies prior to RP were a predictor of continence or potency at different time points. A two-sided p value < 0.05 was considered significant.

Results

Overall continence rates were 84%, 92%, 96%, and 98% at 3, 6, 12, 24 months, respectively. Repeat biopsies prior to RP were associated with lower continence rates at 3 months compared to single biopsy (p=0.03) (Figure); however, no differences were observed at 6, 12, and 24 months. In multivariable analyses adjusting for age, body mass index and Charlson Comorbidity Index, repeat biopsies were associated with a borderline significant lower risk of continence at 3 months (odds ratio 0.68 [95% confidence interval 0.46-1.00; p=0.051], however not at 6, 12, and 24 months._x000D_ Overall potency rates were 16%, 33%, 51%, and 55% at 3, 6, 12, and 24 months, respectively. No differences in potency rates between single biopsy versus repeat biopsies were seen at all time points (Figure). In univariate and multivariable analyses, repeat biopsies were not predictive of potency at any time point._x000D_ _x000D_

Conclusions

Repeat biopsies do not impact mid-term to long-term recovery of continence and potency after RP. These data support the current trend towards active surveillance and delayed local treatment in patients with low- to intermediate-risk prostate cancer._x000D_ _x000D_

Funding

none