MP44-05 SERUM PSA TRENDS AND PROSTATE CANCER DETECTION ON FOLLOW-UP IN MEN WITH A PRIOR NEGATIVE BIOPSY: A COHORT STUDY

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You have accessJournal of UrologyCME1 Apr 2023MP44-05 SERUM PSA TRENDS AND PROSTATE CANCER DETECTION ON FOLLOW-UP IN MEN WITH A PRIOR NEGATIVE BIOPSY: A COHORT STUDY Ankush Modi, Prabhjot Singh, Amlesh Seth, and Rajeev Kumar Ankush ModiAnkush Modi More articles by this author , Prabhjot SinghPrabhjot Singh More articles by this author , Amlesh SethAmlesh Seth More articles by this author , and Rajeev KumarRajeev Kumar More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003290.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Serum PSA above the normal range is the most common trigger for a prostate biopsy. However, the range of normal PSA is poorly defined in many populations. Men with ‘elevated’ PSA may not harbour cancer and it is unclear if such men with a prior negative biopsy should be biopsied again. We conducted a cohort study to assess PSA trends and cancer detection rates in such men with a prior negative biopsy. METHODS: In an IRB approved ambispective study, men who underwent prostate biopsy between January 2016 and December 2021 for PSA>4ng/mL were identified. Among them, those whose biopsy was negative for malignancy were contacted either telephonically or reviewed in person and the most recent PSA and histopathology of any repeat prostate biopsy was determined. These were evaluated to assess the PSA trend, re-biopsy and cancer detection rate. RESULTS: During the study period, a total of 1260 prostate biopsies were performed out of which 444 were negative for malignancy and 241 patients fulfilled the inclusion criteria (Figure 1). Their median pre-biopsy PSA was 16.5 ng/mL (interquartile range [IQR] 7.99-79.39) and median follow up PSA was 9.81 (IQR 7.14-15.6). Follow up PSA had decreased in 177 patients (73.4%), was static in 48 patients (19.9%) and increased in only 16 patients (6.6%). Repeat biopsy was performed in 20 patients, of whom 7 had cancer (35%) with overall positivity rate of 2.9% among those included (Figure 2). Although the positivity rate was higher in men with increased PSA, it was not statistically different from those with lower or similar PSA. No factors could be identified to predict a positive repeat biopsy. CONCLUSIONS: PSA, the sole trigger for a prostate biopsy, declined in nearly three quarters of men with a negative first biopsy and less than 3% men were detected to have cancer on a repeat biopsy. This information could help appropriately counsel patients and allay anxiety after a negative biopsy. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e612 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ankush Modi More articles by this author Prabhjot Singh More articles by this author Amlesh Seth More articles by this author Rajeev Kumar More articles by this author Expand All Advertisement PDF downloadLoading ...