PURPOSE: We hypothesized that there might be a higher incidence of low-risk prostate cancer (PCa) in men diagnosed at a repeated biopsy.
Thus, we investigated differences in clinicopathological results of PCa after primary and repeated biopsy.
MATERIALS AND METHODS: We retrospectively reviewed patients diagnosed with PCa at a primary or repeated biopsy from January 2004 to April 2011. Patients were stratified into primary biopsy and repeated biopsy groups. We analyzed prostate-specific antigen, clinical stage, Gleason score (GS), positive core ratio, and low-risk group by using D'Amico classification. We also investigated GS upgrading and upstaging after radical prostatectomy (RP).
RESULTS: Among 448 primary and 37 repeated biopsy PCa patients, 82 (group 1) and 25 (group 2) underwent RP. The percentage of low-risk patients did not differ significantly between the groups. The positive biopsy core ratio was significantly lower in group 2 (p=0.009). The percentages of GS upgrading and upstaging were 42.7% and 47.6% in group 1, respectively (p=0.568), and 48.0% and 52.0% in group 2, respectively (p=0.901). In the analysis of low-risk patients, GS upgrading and upstaging were not significantly different between the groups (p=0.615 and p=0.959, respectively).
CONCLUSIONS: A lower positive core ratio may imply a small volume of PCa and possibly insignificant PCa in the repeated biopsy group. However, no significant differences were observed for the ratio of low-risk cancers, GS upgrading, or upstaging between the groups. Therefore, PCa diagnosed at a repeated biopsy is not an additional indication for active surveillance.
Written by:
Lee SJ, Hwang I, Hwang EC, Jung SI, Kang TW, Kwon DD, Park K. Are you the author?
Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
Reference: Korean J Urol. 2013 Jun;54(6):364-8.
doi: 10.4111/kju.2013.54.6.364
PubMed Abstract
PMID: 23789043
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