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Abstract:
INTRODUCTION:Digital rectal examination (DRE) is part of the clinical evaluation of men on active surveillance (AS). The purpose of the present study is to analyze the value of DRE as a predictor of upgrading in a population of men with prostate cancer (PC) treated with AS. METHODS:We used the prostate biopsy (PBx) database from an academic center, including PBx from 2006-2018, and identified 2029 confirmatory biopsies (CxPBx) of men treated with AS, of which 726 men had both diagnostic (initial) and CxPBx information available. We did a descriptive analysis and evaluated sensitivity, specificity, and predictive values of DRE for the detection of clinically significant PC (csPC). Multivariable regression analysis was done to identify predictors of csPC. The primary outcome was to evaluate DRE as a predictor of the presence of csPC at CxPBx. RESULTS:Among the 2029 patients with a CxPBx, 75% had PC, and of these, 30.3% had upgrading to ISUP Grade ≥2. Thirteen percent of men had a suspicious DRE (done by their treating physician). Sensitivity, specificity, negative and positive predictive values of DRE to detect csPC were best with a PSA <4 ng/ml (27%, 88%, 31%, and 87%, respectively). A suspicious DRE at CxPBx, particularly if the DRE at diagnosis was negative, was a predictor of csPC (odds ratio [OR] 2.34; p=0.038). The main limitation of our study is the retrospective design and the lack of magnetic resonance imaging. CONCLUSIONS:We believe DRE should still be used as part of AS and can predict the presence of csPC even with low PSA values. A suspicious nodule on DRE represents a higher risk of upgrading and should prompt further assessment.
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最新影响因子:2.052 | 期刊ISSN:1911-6470 | CiteScore: |
出版周期:Bimonthly | 是否OA:YES | 出版年份:2007 |
期刊官方网址:http://www.cua.org/
自引率:6.90% | 研究方向:医学-泌尿学与肾脏学 |
出版地区:CANADA |
SCI期刊coverage:Science Citation Index Expanded(科学引文索引扩展)
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加拿大泌尿学会杂志
大类(学科) | 小类(学科) | 学科排名 |
医学 |
UROLOGY & NEPHROLOGY (泌尿学与肾脏学) 4区 |
64/76 |
年度总发文量 | 年度论文发表量 | 年度综述发表量 |
162 | 120 | 42 |
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