Are More Low-Risk Prostate Cancers Detected by Repeated Biopsy? A Retrospective Pilot Study.
10.4111/kju.2013.54.6.364
- Author:
Seung Je LEE
1
;
Insang HWANG
;
Eu Chang HWANG
;
Seung Il JUNG
;
Taek Won KANG
;
Dong Deuk KWON
;
Kwangsung PARK
Author Information
1. Department of Urology, Chonnam National University Medical School, Gwangju, Korea. drjsi@yahoo.co.kr
- Publication Type:Original Article
- Keywords:
Biopsy;
Prostatectomy;
Prostatic neoplasms
- MeSH:
Biopsy;
Humans;
Incidence;
Male;
Neoplasm Grading;
Passive Cutaneous Anaphylaxis;
Pilot Projects;
Prostate;
Prostate-Specific Antigen;
Prostatectomy;
Prostatic Neoplasms;
Retrospective Studies
- From:Korean Journal of Urology
2013;54(6):364-368
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
