Prostatic bleeding after prostatic biopsy effects oncological outcomes with laparoscopic radical prostatectomy

Tomoaki Takai, Teruo Inamoto, Kazumasa Komura, Takuya Tsujino, Tomohisa Matsunaga, Yuki Yoshikawa, Taizo Uchimoto, Kenkichi Saito, Naoki Tanda, Koichiro Minami, Hirofumi Uehara, Naokazu Ibuki, Kiyoshi Takahara, Hayahito Nomi, Satoshi Kiyama, Hayahito Azuma

Research output: Contribution to journalArticle

Abstract

Background: We vigorously reviewed patients' operation record who had adhesion of the Denonvilliers' fascia and found out most of these patients had prostatic bleeding after prostatic gland biopsies. We examined the magnitude of prostatic bleeding and frequency after biopsies and the relationship with oncological outcomes. Materials and Methods: A total of 285 patients were selected for the final analyses. Inclusion criteria were as follows: Receiving MRI three weeks after biopsiesand laparoscopic radical prostatectomy within 300 days after biopsy. We divided the patients into two groups with (group A) or without (group B) prostatic bleeding. We examined the magnitude of prostatic bleeding after biopsies and the relationship with operation time (OT), positive surgical margin (PSM), biochemical recurrence (BCR) and other factors. Furthermore, we created a logistic-regression model to derive a propensity score for prostatic bleeding after biopsies, which included all patient and hospital characteristics as well as selected interaction terms, and we examined the relationship with PSM and BCR. Results: In all patients, the OT in the group B was shorter than the group A (p < 0.001). Prostatic bleeding was associated with PSM (p=0.000) and BCR (p=0.036). In this propensity-matched cohort, 11 of 116 patients in the group B had PSM as compared with 36 of 116 patients from group A (match-adjusted odds ratio, 4.30; 95%CI confidence interval, 2.06 to 8.96; P=0.000). In addition, eight of 116 patients in group B encountered BCR, as compared with 18 of 116 patients in group A (match-adjusted odds ratio, 2.48; 95%CI, 1.03 to 5.96; P=0.042). Kaplan-Meier analysis in the propensity matching cohort showed a significant biochemical recurrence-free survival advantage for being free of prostate bleeding after biopsies. Conclusions: Our findings in the present cohort should help equip surgeons to pay attention to careful excision especially for those who experienced deferred prostatic bleeding.

Original languageEnglish
Pages (from-to)1373-1377
Number of pages5
JournalAsian Pacific Journal of Cancer Prevention
Volume17
Issue number3
DOIs
Publication statusPublished - 19-04-2016

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Prostatectomy
Hemorrhage
Biopsy
Recurrence
Logistic Models
Odds Ratio
Propensity Score
Fascia
Kaplan-Meier Estimate
Prostate
Confidence Intervals
Survival
Margins of Excision

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Oncology
  • Public Health, Environmental and Occupational Health
  • Cancer Research

Cite this

Takai, Tomoaki ; Inamoto, Teruo ; Komura, Kazumasa ; Tsujino, Takuya ; Matsunaga, Tomohisa ; Yoshikawa, Yuki ; Uchimoto, Taizo ; Saito, Kenkichi ; Tanda, Naoki ; Minami, Koichiro ; Uehara, Hirofumi ; Ibuki, Naokazu ; Takahara, Kiyoshi ; Nomi, Hayahito ; Kiyama, Satoshi ; Azuma, Hayahito. / Prostatic bleeding after prostatic biopsy effects oncological outcomes with laparoscopic radical prostatectomy. In: Asian Pacific Journal of Cancer Prevention. 2016 ; Vol. 17, No. 3. pp. 1373-1377.
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abstract = "Background: We vigorously reviewed patients' operation record who had adhesion of the Denonvilliers' fascia and found out most of these patients had prostatic bleeding after prostatic gland biopsies. We examined the magnitude of prostatic bleeding and frequency after biopsies and the relationship with oncological outcomes. Materials and Methods: A total of 285 patients were selected for the final analyses. Inclusion criteria were as follows: Receiving MRI three weeks after biopsiesand laparoscopic radical prostatectomy within 300 days after biopsy. We divided the patients into two groups with (group A) or without (group B) prostatic bleeding. We examined the magnitude of prostatic bleeding after biopsies and the relationship with operation time (OT), positive surgical margin (PSM), biochemical recurrence (BCR) and other factors. Furthermore, we created a logistic-regression model to derive a propensity score for prostatic bleeding after biopsies, which included all patient and hospital characteristics as well as selected interaction terms, and we examined the relationship with PSM and BCR. Results: In all patients, the OT in the group B was shorter than the group A (p < 0.001). Prostatic bleeding was associated with PSM (p=0.000) and BCR (p=0.036). In this propensity-matched cohort, 11 of 116 patients in the group B had PSM as compared with 36 of 116 patients from group A (match-adjusted odds ratio, 4.30; 95{\%}CI confidence interval, 2.06 to 8.96; P=0.000). In addition, eight of 116 patients in group B encountered BCR, as compared with 18 of 116 patients in group A (match-adjusted odds ratio, 2.48; 95{\%}CI, 1.03 to 5.96; P=0.042). Kaplan-Meier analysis in the propensity matching cohort showed a significant biochemical recurrence-free survival advantage for being free of prostate bleeding after biopsies. Conclusions: Our findings in the present cohort should help equip surgeons to pay attention to careful excision especially for those who experienced deferred prostatic bleeding.",
author = "Tomoaki Takai and Teruo Inamoto and Kazumasa Komura and Takuya Tsujino and Tomohisa Matsunaga and Yuki Yoshikawa and Taizo Uchimoto and Kenkichi Saito and Naoki Tanda and Koichiro Minami and Hirofumi Uehara and Naokazu Ibuki and Kiyoshi Takahara and Hayahito Nomi and Satoshi Kiyama and Hayahito Azuma",
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Takai, T, Inamoto, T, Komura, K, Tsujino, T, Matsunaga, T, Yoshikawa, Y, Uchimoto, T, Saito, K, Tanda, N, Minami, K, Uehara, H, Ibuki, N, Takahara, K, Nomi, H, Kiyama, S & Azuma, H 2016, 'Prostatic bleeding after prostatic biopsy effects oncological outcomes with laparoscopic radical prostatectomy', Asian Pacific Journal of Cancer Prevention, vol. 17, no. 3, pp. 1373-1377. https://doi.org/10.7314/APJCP.2016.17.3.1373

Prostatic bleeding after prostatic biopsy effects oncological outcomes with laparoscopic radical prostatectomy. / Takai, Tomoaki; Inamoto, Teruo; Komura, Kazumasa; Tsujino, Takuya; Matsunaga, Tomohisa; Yoshikawa, Yuki; Uchimoto, Taizo; Saito, Kenkichi; Tanda, Naoki; Minami, Koichiro; Uehara, Hirofumi; Ibuki, Naokazu; Takahara, Kiyoshi; Nomi, Hayahito; Kiyama, Satoshi; Azuma, Hayahito.

In: Asian Pacific Journal of Cancer Prevention, Vol. 17, No. 3, 19.04.2016, p. 1373-1377.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prostatic bleeding after prostatic biopsy effects oncological outcomes with laparoscopic radical prostatectomy

AU - Takai, Tomoaki

AU - Inamoto, Teruo

AU - Komura, Kazumasa

AU - Tsujino, Takuya

AU - Matsunaga, Tomohisa

AU - Yoshikawa, Yuki

AU - Uchimoto, Taizo

AU - Saito, Kenkichi

AU - Tanda, Naoki

AU - Minami, Koichiro

AU - Uehara, Hirofumi

AU - Ibuki, Naokazu

AU - Takahara, Kiyoshi

AU - Nomi, Hayahito

AU - Kiyama, Satoshi

AU - Azuma, Hayahito

PY - 2016/4/19

Y1 - 2016/4/19

N2 - Background: We vigorously reviewed patients' operation record who had adhesion of the Denonvilliers' fascia and found out most of these patients had prostatic bleeding after prostatic gland biopsies. We examined the magnitude of prostatic bleeding and frequency after biopsies and the relationship with oncological outcomes. Materials and Methods: A total of 285 patients were selected for the final analyses. Inclusion criteria were as follows: Receiving MRI three weeks after biopsiesand laparoscopic radical prostatectomy within 300 days after biopsy. We divided the patients into two groups with (group A) or without (group B) prostatic bleeding. We examined the magnitude of prostatic bleeding after biopsies and the relationship with operation time (OT), positive surgical margin (PSM), biochemical recurrence (BCR) and other factors. Furthermore, we created a logistic-regression model to derive a propensity score for prostatic bleeding after biopsies, which included all patient and hospital characteristics as well as selected interaction terms, and we examined the relationship with PSM and BCR. Results: In all patients, the OT in the group B was shorter than the group A (p < 0.001). Prostatic bleeding was associated with PSM (p=0.000) and BCR (p=0.036). In this propensity-matched cohort, 11 of 116 patients in the group B had PSM as compared with 36 of 116 patients from group A (match-adjusted odds ratio, 4.30; 95%CI confidence interval, 2.06 to 8.96; P=0.000). In addition, eight of 116 patients in group B encountered BCR, as compared with 18 of 116 patients in group A (match-adjusted odds ratio, 2.48; 95%CI, 1.03 to 5.96; P=0.042). Kaplan-Meier analysis in the propensity matching cohort showed a significant biochemical recurrence-free survival advantage for being free of prostate bleeding after biopsies. Conclusions: Our findings in the present cohort should help equip surgeons to pay attention to careful excision especially for those who experienced deferred prostatic bleeding.

AB - Background: We vigorously reviewed patients' operation record who had adhesion of the Denonvilliers' fascia and found out most of these patients had prostatic bleeding after prostatic gland biopsies. We examined the magnitude of prostatic bleeding and frequency after biopsies and the relationship with oncological outcomes. Materials and Methods: A total of 285 patients were selected for the final analyses. Inclusion criteria were as follows: Receiving MRI three weeks after biopsiesand laparoscopic radical prostatectomy within 300 days after biopsy. We divided the patients into two groups with (group A) or without (group B) prostatic bleeding. We examined the magnitude of prostatic bleeding after biopsies and the relationship with operation time (OT), positive surgical margin (PSM), biochemical recurrence (BCR) and other factors. Furthermore, we created a logistic-regression model to derive a propensity score for prostatic bleeding after biopsies, which included all patient and hospital characteristics as well as selected interaction terms, and we examined the relationship with PSM and BCR. Results: In all patients, the OT in the group B was shorter than the group A (p < 0.001). Prostatic bleeding was associated with PSM (p=0.000) and BCR (p=0.036). In this propensity-matched cohort, 11 of 116 patients in the group B had PSM as compared with 36 of 116 patients from group A (match-adjusted odds ratio, 4.30; 95%CI confidence interval, 2.06 to 8.96; P=0.000). In addition, eight of 116 patients in group B encountered BCR, as compared with 18 of 116 patients in group A (match-adjusted odds ratio, 2.48; 95%CI, 1.03 to 5.96; P=0.042). Kaplan-Meier analysis in the propensity matching cohort showed a significant biochemical recurrence-free survival advantage for being free of prostate bleeding after biopsies. Conclusions: Our findings in the present cohort should help equip surgeons to pay attention to careful excision especially for those who experienced deferred prostatic bleeding.

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