Radical Prostatectomy Without Prior Biopsy? Final Histopathology of Radical Prostatectomies in 103…

Cohort studyEuropean urology focus· Aug 2026

Radical Prostatectomy Without Prior Biopsy? Final Histopathology of Radical Prostatectomies in 103 Consecutive Biopsy-naïve Patients Who Underwent Radical Prostatectomy.

Marie Semmler, Julian Marcon, Elena K Berg … Robert Bischoff

Surgical PathologyCohort studyQ1IF 4.2

Nearly all patients undergoing radical prostatectomy without prior biopsy had clinically significant prostate cancer.

Radical Prostatectomy Without Prior Biopsy? Final Histopathology of Radical Prostatectomies in 103 Consecutive Biopsy-naïve Patients Who Underwent Radical Prostatectomy.

Marie Semmler … Robert Bischoff

European urology focus · Aug 2026 · Q1 in Urology

Background

Prostate biopsy for histological confirmation is the standard before radical prostatectomy (radical prostatectomy).

Purpose

This study aimed to evaluate final pathology, assess potential active surveillance (active surveillance) eligibility, and exploratorily evaluate perioperative outcomes and short-term oncological biochemical recurrence (biochemical recurrence)-free survival after biopsy-naïve radical prostatectomy (bnRP).

Methods

We retrospectively analyzed a single-center cohort of patients who underwent bnRP with T2-pT3 disease between 2019 and 2026.

n = 103 consecutive bnRP specimens

Results

94%

nearly every biopsy-naive prostatectomy found clinically significant cancer

n = 103 consecutive bnRP specimens

More results

In 103 consecutive bnRP specimens, prostate cancer was confirmed in all patients.

Compared with 3081 consecutive patients who underwent bcRP, patients who underwent bnRP had fewer low-grade tumors and more locally advanced disease.

More results

Overall, 5.8% of the biopsy-naïve patients had International Society of Urological Pathology grade group 1 disease, but only one patient fulfilled the stricter active surveillance approximation criteria.

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Conclusion · 1 of 2

In our single-center observational analysis of carefully selected patients, bnRP seemed safe and was associated with a high likelihood of csPCa.

Conclusion · 2 of 2

Nevertheless, the retrospective approximation of active surveillance eligibility highlights that bnRP should be performed cautiously. Exploratory perioperative and short-term oncological analyses need prospective validation.

Radical Prostatectomy Without Prior Biopsy? Final Histopathology of Radical Prostatectomies in 103 Consecutive Biopsy-naïve Patients Who Underwent Radical Prostatectomy.

Radical Prostatectomy Without Prior Biopsy? Final Histopathology of Radical Prostatectomies in 103 Consecutive Biopsy-naïve Patients Who Underwent Radical Prostatectomy.

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