Yield from Routine Prostatic Needle Biopsy in Patients more than 50 Years Old Referred for Urologic Evaluation: A Preliminary Report

Abstract

Approximately 10% of the patients undergoing simple prostatectomy for presumed benign disease have clinically unsuspected prostatic carcinoma. In these patients curative treatments, such as radical prostatectomy and some forms of radiation therapy, often are compromised by the simple prostatectomy. To determine whether routine prostatic needle biopsy would be practical to identify patients with occult carcinoma a prospective study was initiated of routine needle biopsy in patients more than 50 yr old referred for urologic evaluation. Consecutive patients (71) were biopsied, 21 of whom underwent subsequent simple prostatectomy after negative needle biopsy. Carcinoma was found in none of 24 men not having prostatic induration, 4 of 36 (11%) with minimal induration and 5 of 11 (45%) with marked induration. The vast majority of the patients with prostatic carcinomas apparently has some degree of palpable induration; a high index of suspicion appears warranted when any prostatic induration is present on digital rectal examination.