Does low-risk prostate cancer detection change with repeat biopsies?

摘要

Many patients with a negative prostate biopsy (PBx) but persistent clinical suspicion of prostate cancer (PCa) undergo repeat PBx. On repeat PBx, there are higher rates of low-grade and organ-confined PCa, which are associated with lower risk of disease progression and cancer-specific mortality. Increasing emphasis is being placed on treating only clinically significant disease. We hypothesize that a considerable risk of clinically significant PCa remains on repeat PBx. Therefore, we reviewed a contemporary cohort of patients who underwent one or more PBx.We retrospectively reviewed the data from a cohort of 25 584 patients who underwent PBx at two institutions.One dedicated uropathologist evaluated 90% of PBx specimens; the remaining specimens were evaluated by two other uropathologists. To ensure current pathologic grading standards, the study was limited to patients biopsied from 2004 to 2010. Only patients with at least 10 cores taken were included. Statistical analysis was performed using SPSS v.l7.0 (SPSS Inc., IBM Corp., Armonk, NY, USA). Descriptive statistics are reported as medians with interquartile ranges (IQRs). All tests were two-sided, and a p value of 0.05 was considered statistically significant.