247 REPEAT PROSTATE BIOPSY AND THE INCREMENTAL RISK OF CLINICALLY INSIGNIFICANT PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology and Natural History II1 Apr 2010247 REPEAT PROSTATE BIOPSY AND THE INCREMENTAL RISK OF CLINICALLY INSIGNIFICANT PROSTATE CANCER Matthew Resnick, Daniel Lee, Keith VanArsdalen, Alan Wein, S. Bruce Malkowicz, and Thomas Guzzo Matthew ResnickMatthew Resnick More articles by this author , Daniel LeeDaniel Lee More articles by this author , Keith VanArsdalenKeith VanArsdalen More articles by this author , Alan WeinAlan Wein More articles by this author , S. Bruce MalkowiczS. Bruce Malkowicz More articles by this author , and Thomas GuzzoThomas Guzzo More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.306AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To determine the incremental increase in risk of diagnosis of clinically insignificant prostate cancer with serial prostate biopsies. METHODS We reviewed our radical prostatectomy (RP) database comprising 2411 consecutive patients undergoing RP. We then stratified patients by the prostate biopsy on which their cancer was diagnosed and correlated biopsy number with the risk of clinically insignificant disease, defined as pathologic Gleason score 6 or less, < 10% estimated tumor volume, no extracapsular extension (ECE), seminal vesicle inasion (SVI), positive surgical margin (PSM), or positive lymph node(s). We also correlated biopsy number with adverse pathology at RP, defined as pathologic Gleason score 7 or higher, > 25% estimated tumor volume, ECE, SVI, PSM, or positive lymph node(s). RESULTS A total of 1955 (81.0%), 281 (11.7%), and 175 (7.3%) patients underwent 1, 2, and 3 prostate biopsies, respectively prior to RP. Increasing number of prostate biopsies was associated with increasing prostate volume (p<0.01), PSA (p<0.01), associated PIN (p<0.01), and increased likelihood of clinical Gleason 6 or less disease (p<0.01). On pathologic analysis, increasing number of prostate biopsies was associated with increased risk of low volume (p<0.01), organ-confined (p<0.01) disease. The risk of clinically insignificant disease was found to be 31.1%, 43.8%, and 46.8% in those undergoing 1, 2, and 3+ prostate biopsies, respectively. Conversely, the risk of adverse pathology was found to be 64.6%, 53.0%, and 52.0% in those undergoing 1, 2, and 3+ prostate biopsies, respectively. CONCLUSIONS Serial prostate biopsy is associated with an incremental rise in the risk of clinically insignificant prostate cancer. Patients should be counseled about this risk when considering repeat prostate biopsy. Philadelphia, PA© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e97 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matthew Resnick More articles by this author Daniel Lee More articles by this author Keith VanArsdalen More articles by this author Alan Wein More articles by this author S. Bruce Malkowicz More articles by this author Thomas Guzzo More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...