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The impact of complications after initial prostate biopsy on repeat protocol biopsy acceptance rate. Results from the Prostate Cancer Research International: Active Surveillance JAPAN study

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A Correction to this article was published on 03 March 2022

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Abstract

Background

Patients with favorable-risk prostate cancer on active surveillance (AS) are strictly followed for safer execution. Repeat protocol biopsy is essential for evaluating cancer aggressiveness. However, the acceptance rate of repeat biopsy is not high enough because of the burdens of biopsy. We assessed the impact of complications after the initial biopsy on repeat protocol biopsy at 1 year using data from the Prostate Cancer Research International: Active Surveillance (PRIAS)-JAPAN study.

Methods

We performed a retrospective analysis using a prospective cohort in the PRIAS-JAPAN study. Patients with favorable-risk prostate cancer (n = 856) who consented to participate in the PRIAS-JAPAN study from 2010 to 2018 were enrolled. Follow-up evaluations included regular prostate-specific antigen, digital rectal examination and biopsy. Rates of complications after biopsies and repeat protocol biopsy non-acceptance rate at 1 year were reported. Logistic regression analysis explored the association between the complications after the initial biopsy and repeat protocol biopsy non-acceptance.

Results

Altogether, 759 patients (88.7%) actually proceeded to protocol at 1 year. Repeat protocol biopsy non-acceptance rate at 1 year was 14.9%. Regarding complications after the initial biopsy, hematuria (p = 0.028) and pain (p < 0.001) rates were significantly higher in the repeat biopsy non-acceptance group, but infection (p = 0.056) and hematospermia (p = 0.337) rates were not different. On multivariate logistic regression analysis, pain was a significant predictor for repeat protocol biopsy non-acceptance (odds ratio 4.68, 95% confidence interval 1.864–11.75; p = 0.001).

Conclusions

Pain at the initial biopsy negatively impacts patients’ compliance with further protocol biopsies during AS.

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Acknowledgements

The authors thank Dr Shintaro Narita, Dr Wataru Obara, Dr Mitsugu Kanehira, Dr Kazuo Nishimura, Dr Masashi Nakayama, Dr Norio Nonomura, Dr Motohide Uemura, Dr Kenichi Tabata, Dr Hideyasu Tsumura, Dr Hiroshi Okuno, Dr Takayoshi Miura, Dr Osamu Ogawa, Dr Shusuke Akamatsu, Dr Osamu Ukimura, Dr Takumi Shiroishi, Dr Hiroshi Fukuhara, Dr Tomomi Kamba, Dr Yoji Murakami, Dr Yasuo Yamamoto, Dr Tadashi Murata, Dr Akito Terai, Dr Hirohito Naito, Dr Kazuhiro Suzuki, Dr Yukio Kageyama, Dr Masaharu Inoue, Dr Kohei Hashimoto, Dr Naoya Masumori, Dr Yukio Naya, Dr Satoko Kojima, Dr Akira Miyajima, Dr Masahiro Nitta, Dr Koichiro Akakura, Dr Hiroyoshi Suzuki, Dr Naoto Kamiya, Dr Hiro-omi Kanayama, Dr Yoshito Kusuhara, Dr Kiyotaka Kawashima, Dr Hideki Sakai, Dr Tomoaki Hakariya, Dr Toshitaka Tanikawa, Dr Toshihiro Saito, Dr Yoshihiko Tomita, Dr Takashi Kasahara, Dr Takayuki Sugiyama, Dr Hideaki Miyake, Dr Jun Teishima, Dr Takeshi Ueno, Dr Takashige Abe, Dr Satoru Maruyama, Dr Toshiyuki Kamoto, Dr Naoki Terada, Dr Norihiko Tsuchiya, Dr Hidenori Kanno, Dr Hiroaki Matsumoto, Dr Seiichi Saito, Dr Hiromi Hirama, Dr Takashi Kimura, and Dr Isao Hara for their great contribution to this study.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Urology, Faculty of Medicine, Kagawa University, 1750-1, Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan

    Yoichiro Tohi, Takuma Kato, Yoshiyuki Kakehi & Mikio Sugimoto

  2. Department of Renal and Genito-Urinary Surgery, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan

    Ryuji Matsumoto & Nobuo Shinohara

  3. Division of Urology, Harasanshin Hospital, Fukuoka, Japan

    Kenichiro Shiga & Akira Yokomizo

  4. Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Masaki Nakamura & Haruki Kume

  5. Department of Urology, Tohoku University Graduate School of Medicine, Miyagi, Japan

    Koji Mitsuzuka

  6. Department of Urology, Jikei University School of Medicine, Tokyo, Japan

    Hiroshi Sasaki & Shin Egawa

  7. Department of Urology, Shikoku Cancer Center, Ehime, Japan

    Masafumi Matsumura & Katsuyoshi Hashine

  8. Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Junichi Inokuchi & Masatoshi Eto

  9. Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan

    Haruki Baba & Tomohiko Ichikawa

  10. Department of Urology and Andrology, General Medical Center, Kansai Medical University, Osaka, Japan

    Hidefumi Kinoshita & Tadashi Matsuda

Authors
  1. Yoichiro Tohi
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  2. Takuma Kato
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  5. Kenichiro Shiga
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  6. Akira Yokomizo
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  7. Masaki Nakamura
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  8. Haruki Kume
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Contributions

YT, TK, MS The conception or design of the work. YT, TK, RM, NS, KS, AY, MN, HK, KM, HS, SE, MM, KH, JI, ME, HB, TI, HK, TM, YK, MS: The acquisition of data for the work. YT: Analysis and interpretation of data for the work. YT: Drafting the work. TK, RM, NS, KS, AY, MN, HK, KM, HS, SE, MM, KH, JI, ME, HB, TI, HK, TM, YK, MS: Revising the work critically. TK, RM, NS, KS, AY, MN, HK, KM, HS, SE, MM, KH, JI, ME, HB, TI, HK, TM, YK, MS: Final approval of the version to be published.

Corresponding author

Correspondence to Yoichiro Tohi.

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Conflict of interest

Dr Nobuo Shinohara received honoraria from Takeda Pharmaceutical Co. Ltd, Bayer Co. Ltd, Astellas Pharmaceutical Co. Ltd, Ono Pharmaceutical Co. Ltd, Pfizer Co Ltd, Novartis Pharmaceutical Co. Ltd, and AstraZeneca Co. Ltd, and received research funding from Ono Pharmaceutical Co. Ltd and Astellas Pharmaceutical Co. Ltd. Dr Masatoshi Eto received honoraria from Takeda Pharmaceutical Co. Ltd and Janssen Pharmaceutical Co. Ltd, and received research funding from Sanofi Co. Ltd, Bayer Co. Ltd, Astellas Pharmaceutical Co. Ltd and Takeda Pharmaceutical Co. Ltd. Dr Shin Egawa received scholarship donations from Takeda Pharmaceutical Co. Ltd, Kissei Pharmaceutical Co. Ltd, Ono Pharmaceutical Co. Ltd and Bayer Co. Ltd. Dr Akira Yokomizo received honoraria from Astellas Pharmaceutical Co. Ltd, Sanofi Co. Ltd and Bayer Co. Ltd. Dr Mikio Sugimoto received honoraria from Astellas Pharmaceutical Co. Ltd, Janssen Pharmaceutical Co. Ltd, Takeda Pharmaceutical Co. Ltd and AstraZeneca Co. Ltd, and received researching funding from Astellas Pharmaceutical Co. Ltd, Janssen Pharmaceutical Co. Ltd, AstraZeneca Co. Ltd, Bayer Co. Ltd, Ono Pharmaceutical Co. Ltd, Shin Nippon Biomedical Laboratories Ltd, Eisai Co. Ltd, and Merck Ltd, and received scholarship donations from Astellas Pharmaceutical Co. Ltd, Takeda Pharmaceutical Co. Ltd, Bayer Co. Ltd and Pfizer Co Ltd. Other authors declare that they have no conflict of interest.

Ethical approval

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and its later amendments.

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The original publication has been updated due to inclusion of missing entries in Table 4.

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Tohi, Y., Kato, T., Matsumoto, R. et al. The impact of complications after initial prostate biopsy on repeat protocol biopsy acceptance rate. Results from the Prostate Cancer Research International: Active Surveillance JAPAN study. Int J Clin Oncol 25, 2107–2114 (2020). https://doi.org/10.1007/s10147-020-01761-3

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