PD26-10 INCIDENCE OF CLINICALLY-SIGNIFICANT PROSTATE CANCER AFTER A DIAGNOSIS OF ATYPICAL SMALL ACINAR PROLIFERATION (ASAP), PROSTATIC INTRAEPITHELIAL NEOPLASIA (PIN), OR BENIGN TISSUE

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening VI1 Apr 2016PD26-10 INCIDENCE OF CLINICALLY-SIGNIFICANT PROSTATE CANCER AFTER A DIAGNOSIS OF ATYPICAL SMALL ACINAR PROLIFERATION (ASAP), PROSTATIC INTRAEPITHELIAL NEOPLASIA (PIN), OR BENIGN TISSUE Scott Wiener, Peter Haddock, Ilene Staff, and Joseph Wagner Scott WienerScott Wiener More articles by this author , Peter HaddockPeter Haddock More articles by this author , Ilene StaffIlene Staff More articles by this author , and Joseph WagnerJoseph Wagner More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.371AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Repeat prostate biopsy after an initial biopsy that fails to demonstrate cancer may reveal ′clinically-significant′ or ′insignificant′ cancer (based upon Gleason score, volume of disease, and PSA). Here, we assess the incidence of clinically significant and insignificant prostate cancer after an initial biopsy revealed either ASAP, PIN, or benign tissue. METHODS We retrospectively identified patients who underwent repeat biopsy within 1 year at our clinical center during 1987-2015 and were diagnosed with either ASAP, PIN, or benign tissue after an initial biopsy. The incidence of clinically-significant cancer (Gleason ≥7, or Gleason 6 plus any of the following: PSA >10, or ≥3 cores positive, or >50% core volume) was compared between each cohort. RESULTS 17,016 sets of biopsies in 12,817 patients were performed during 1987-2015. In patients who underwent rebiopsy within 1 year, 261 (42.4%), 208 (33.8%) and 147 (23.8%) had ASAP, PIN or benign tissue, respectively, on initial biopsy. There were no statistical differences between the groups for the rate of detecting clinically significant cancer (8.0%, 6.7%, and 4.1%, respectively, p=0.31). The overall rate of cancer (clinically-significant or not) was statistically different among the three groups (26.1%, 13.5%, and 11.6%, respectively; p<0.001). Pair-wise comparisons indicate that the ASAP group differed from the other two (p<0.001 vs. benign and p=0.001 vs. PIN). CONCLUSIONS On repeat biopsy within 1 year, the incidence of clinically-significant prostate cancer is of a similarly low rate in patients who either harbor benign tissue, PIN, or ASAP on an initial biopsy. Elevated rates of prostate cancer detection after a diagnosis of ASAP thus appear to be largely due to differences in the rate of clinically-insignificant disease. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e648 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Scott Wiener More articles by this author Peter Haddock More articles by this author Ilene Staff More articles by this author Joseph Wagner More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...