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Does prostate biopsy come with a mortality risk?

Posted Sep 29 2008 4:46pm

The “New” Prostate Can InfoLink does not believe that recently published data necessarily implies that prostate biopsy is associated with increased risk of death at 120 days. However, the data presented in a paper just published does suggest that a careful analysis of this risk may be important.

The transrectal ultrasound-guided biopsy represents the diagnostic standard for prostate cancer, but its mortality rate has never been examined.  Gallina et al.  performed a population-based study of 120-day mortality after prostate biopsy in 22,175 patients who underwent prostate biopsy between 1989 and 2000. The control group consisted of 1,778 men aged 65-85 years (median 69.5), who did not undergo a biopsy.

The critical results of this analysis were as follows:

  • Based on data from 11,087 of the 22,175 men (50 percent) subjected to prostate biopsy, predictors of 120-day mortality were age at biopsy, baseline Charlson comorbidity index and cumulative number of biopsy procedures.
  • Using the remaining 50 percent of men receiving biopsy, the model suggests that overall 120-day mortality after biopsy was 1.3 percent versus 0.3% in the control group(p < 0.001).
  • Of men aged &le; 60 years, 0.2 percent died within 120 days versus 2.5 percent aged 76-80. 
  • First ever biopsy procedures carried a higher mortality risk than subsequent procedures (1.4 vs. 0.8 vs. 0.6 percent).

Overall, the model’s variables were 79 percent accurate in predicting the probability of 120-day mortality after biopsy. The authors conclude that their data “suggest that prostate biopsy might predispose to higher mortality rate. The certainty of this association remains to be proven.”

As stated above, these data should not, at this time, be used to suggest that modern prostate biopsy is a particularly risky procedure, since this is a retrospective statistical analysis going back nearly 20 years in total. However, it is reasonable to expect some further investigation of this issue, since prostate biopsy has generally been assumed to have minimal (if any) mortality risk.

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