Prostate cancers diagnosed at repeat biopsy are smaller and less likely to be high grade
Abstract
We investigated whether prostate cancer diagnosed on initial prostate biopsy had worse pathological outcomes compared to that diagnosed on repeat prostate biopsy. We reviewed 905 newly diagnosed prostate cancer cases from 2000 to 2007. Patients were stratified by the number of previous biopsies, including the initial biopsy in 690, and 1 and 2 or greater negative previous biopsies in 142 and 73, respectively. We analyzed Gleason sum, number of cores taken, percent of positive cores and bilaterality of prostate cancer. Clinically insignificant cancers were defined according to prostate specific antigen density 0.4 ng/ml or less, 3 or fewer positive cores, 50% or less of maximum cancer in any core and Gleason sum 6 or less. Prostate cancer was diagnosed in 57%, 23% and 21% of cases in the initial, and 1 and 2 or greater negative previous biopsies groups, respectively. Initial prostate biopsy showed a higher number and percent of positive cores, and the maximum percent of prostate cancer involved in a core. However, the Gleason pattern distribution differed significantly in the 3 groups with the highest percent (14%) of Gleason sum 8 or greater in the subset with 2 or greater negative previous biopsies (p <0.01). On multivariate a...Continue Reading
References
Longitudinal evaluation of prostate-specific antigen levels in men with and without prostate disease
Citations
Percentage of free prostate-specific antigen: implications in modern extended scheme prostate biopsy
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