1923 PROSTATE CANCER DETECTION AFTER DIAGNOSIS OF ATYPICAL SMALL ACINAR PROLIFERATION

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening III1 Apr 20121923 PROSTATE CANCER DETECTION AFTER DIAGNOSIS OF ATYPICAL SMALL ACINAR PROLIFERATION Alexandre Rosen, Kyle Kiriluk, Scott Eggener, Gladell Paner, and Glen Gerber Alexandre RosenAlexandre Rosen Chicago, IL More articles by this author , Kyle KirilukKyle Kiriluk Chicago, IL More articles by this author , Scott EggenerScott Eggener Chicago, IL More articles by this author , Gladell PanerGladell Paner Chicago, IL More articles by this author , and Glen GerberGlen Gerber Chicago, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2080AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Atypical small acinar proliferation (ASAP) is diagnosed in 0.9 – 7.8% of prostate biopsies and is associated with an increased likelihood of prostate cancer on subsequent biopsies. Subsequent biopsy cancer detection rates vary from 27 – 59%. The focus of this study is to evaluate the significance of ASAP and subsequent cancer detection rates. METHODS A literature review focusing on the diagnosis of ASAP on prostate biopsy was performed using Medline to assess the published rates of prostate cancer on biopsy after ASAP diagnosis. The clinical and pathological records of 626 men who underwent 12-core prostate biopsy at the University of Chicago Medical Center between July 2008 and October 2010 were reviewed. The indication for biopsy included either an elevated PSA or suspicious DRE. Selection criteria included patients who had a biopsy revealing ASAP without evidence of cancer and subsequently underwent repeat biopsy at our same institution. Patients with a previous diagnosis of prostate cancer prior to the detection of ASAP were excluded. Pathology results including presence of ASAP or cancer, number of involved cores, and Gleason score were analyzed along with PSA values prompting initial biopsy. RESULTS During the 27-month period, 626 patients underwent prostate biopsy. Forty-eight patients (8%) had ASAP without concurrent cancer and were included in the analysis. Thirty-one patients (65%) with an initial biopsy revealing ASAP underwent repeat biopsy. Of these patients, six (20%) had a repeat diagnosis of ASAP on subsequent biopsy, fifteen (48%) had benign tissue, and ten (32%) were diagnosed with cancer. Of those diagnosed with cancer, eight patients were diagnosed with a score of Gleason 6 (80%) and two with Gleason 7 (20%). In patients diagnosed with ASAP, twenty-eight (58%) had one core positive, five (10%) had more than one core positive, and fifteen (31%) did not have a number of involved cores listed. Cancer was diagnosed in 22% of patients with a single ASAP core versus 60% of patients with more than one ASAP core. There was no statistically significant difference in PSA values of patients with ASAP undergoing biopsy and those who were subsequently diagnosed with cancer (7.47 ng/ml and 6.63 ng/ml, respectively; p=0.727). CONCLUSIONS ASAP found in multiple biopsy cores is associated with higher cancer detection rates on subsequent biopsy. Prior to repeat biopsy, the potential clinical significance of an underlying malignancy should be considered as these tend to be low-volume, low-risk cancers. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e776 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alexandre Rosen Chicago, IL More articles by this author Kyle Kiriluk Chicago, IL More articles by this author Scott Eggener Chicago, IL More articles by this author Gladell Paner Chicago, IL More articles by this author Glen Gerber Chicago, IL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...