1990 PATHOLOGIC FINDINGS ON REPEAT PROSTATE BIOPSY FOR AN INITIAL DIAGNOSIS OF ATYPICAL GLANDS SUSPICIOUS FOR MALIGNANCY

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening III1 Apr 20101990 PATHOLOGIC FINDINGS ON REPEAT PROSTATE BIOPSY FOR AN INITIAL DIAGNOSIS OF ATYPICAL GLANDS SUSPICIOUS FOR MALIGNANCY Ryan P. Kopp, Jonathan Shiau, Jessica Wang-Rodriguez, Seth A. Cohen, Jonathan L. Silberstein, Tracy Downs, Ithaar H. Derweesh, Christopher J. Kane, and Kyoko Sakamoto Ryan P. KoppRyan P. Kopp More articles by this author , Jonathan ShiauJonathan Shiau More articles by this author , Jessica Wang-RodriguezJessica Wang-Rodriguez More articles by this author , Seth A. CohenSeth A. Cohen More articles by this author , Jonathan L. SilbersteinJonathan L. Silberstein More articles by this author , Tracy DownsTracy Downs More articles by this author , Ithaar H. DerweeshIthaar H. Derweesh More articles by this author , Christopher J. KaneChristopher J. Kane More articles by this author , and Kyoko SakamotoKyoko Sakamoto More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2001AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The ultimate pathologic and clinical significance of atypical glands suspicious for malignancy (atypia) on prostate biopsy is unclear. We investigated the pathologic characteristics of patients who underwent repeat biopsy for atypia found on initial prostate biopsy. METHODS After IRB-approval, we identified all patients at the San Diego VA Medical Center (SDVAMC) who underwent prostate biopsy and had findings of atypia from 12/1999 through 10/2009. We excluded patients if they had a concurrent diagnosis of prostate cancer (CaP) or failed to have a repeat prostate biopsy. Clinical and pathologic characteristics were analyzed. We compared data between those with CaP (group 1) and those without CaP (group 2) on repeat biopsy. Pathologic outcomes were analyzed for the patients in group 1 who underwent radical prostatectomy. Statistical analysis was performed with SPSS version 17.0. P value <0.05 was significant. RESULTS 379 patients had atypia and 125 with atypia met inclusion criteria. For the entire cohort (group1 and group 2), mean age was 63±8.2 years, median PSA (ng/ml) 4.82±5.01, median PSAd (ng/ml/cc) 0.073±0.065, and number of cores obtained was <12 (26%), 12 (54%), >12 (19%) Median time between biopsy with atypia and repeat biopsy was 7±17 months. 29% (36/125) had CaP on repeat biopsy. Grade on repeat biopsy was Gleason sum 6 (69%), Gleason 7 (22%), Gleason 8 (6%).There were no significant differences between group 1 and group 2 in age, race, family history of PCa, indication for biopsy, number of prior biopsies, PSA, PSAd, prostate volume, duration of follow up, time to repeat biopsy, instance of multiple repeat biopsies, and number of cores obtained. The proportion with inflammation present on biopsy was 47% group 1 vs. 73% group 2 (P = 0.007). 14 patients in group 1 underwent radical prostatectomy; 50% (7/14) were pT2c, 21% (3/14) pT3, 36% (5/14) pathologic Gleason sum 7, 7% (1/14) Gleason 8, 1 extracapsular extension, 2 positive margins, 1 node positive. CONCLUSIONS We demonstrate that a high number of patients (29%) initially found to have atypia will have CaP on repeat biopsy, of which 61% (18% of patients with atypia) were D'Amico intermediate or high risk. Concurrent atypia and inflammation were common and more likely in patients without CaP on repeat biopsy. Atypia is associated with a high risk of significant cancer on repeat biopsy. San Diego, CA© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e773 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ryan P. Kopp More articles by this author Jonathan Shiau More articles by this author Jessica Wang-Rodriguez More articles by this author Seth A. Cohen More articles by this author Jonathan L. Silberstein More articles by this author Tracy Downs More articles by this author Ithaar H. Derweesh More articles by this author Christopher J. Kane More articles by this author Kyoko Sakamoto More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...