Diagnostic yield and early outcomes of radical prostatectomy without prior histopathologic diagnosis: a single-arm systematic review and meta-analysis.

What was studied

This review looked at prostate surgery done without a biopsy first. The men had a high suspicion of significant prostate cancer. This was based on MRI or PSMA-PET scans and PSA tests. The team pooled results from 11 studies with 648 patients. They looked at tissue findings, cancer outcomes and body function.

What they found

Significant cancer was found in a high share of the men. Benign findings were rare. The yield was higher in men with no earlier biopsy. It was lower in men with a past negative biopsy (p = 0.005). The abstract says early urinary and erectile function looked favorable. Reporting on function was uneven and incomplete.

What it means for patients

The authors say the approach gave a high yield of significant cancer. They say it led to few benign surgeries. They say the positive margin rate remains a concern. They say it should be kept for carefully selected patients at high-volume centers.

Why it is not certain yet

There was no comparison group. Risk of bias was serious, mainly from how patients were picked. The function results were descriptive only. The authors say further prospective studies need to confirm these findings.

Source

Diagnostic yield and early outcomes of radical prostatectomy without prior histopathologic diagnosis: a single-arm systematic review and meta-analysis.

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