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Serial Prostatic Biopsies in Men with Persistently Elevated Serum Prostate Specific Antigen Values

1994; Lippincott Williams & Wilkins; Volume: 151; Issue: 6 Linguagem: Inglês

10.1016/s0022-5347(17)35304-1

1527-3792

David W. Keetch, William J. Catàlona, Deborah S. Smith,

Urologic and reproductive health conditions

No AccessJournal of Urology1 Jun 1994Serial Prostatic Biopsies in Men with Persistently Elevated Serum Prostate Specific Antigen Values David W. Keetch, William J. Catalona, and Deborah S. Smith David W. KeetchDavid W. Keetch , William J. CatalonaWilliam J. Catalona , and Deborah S. SmithDeborah S. Smith View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)35304-1AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail The objective of this study was to determine the need for repeat prostatic biopsies in men whose initial biopsy results revealed no evidence of cancer or atypia. We evaluated 1,136 men who underwent 1 or more prostatic biopsies in a longitudinal prostate specific antigen (PSA) based prostate cancer screening study that called for biopsy if the serum PSA level was greater than 4.0ng./ml. (Hybritech assay) and findings on rectal examination or ultrasonography were abnormal or suspicious for cancer. Of the 1,136 men who underwent prostatic biopsy 391 (34%) had prostate cancer on the initial biopsy. Of 427 men who had negative initial biopsy results, a persistent serum PSA level of greater than 4.0ng./ml. and abnormal rectal or ultrasound examination findings 82 (19%) had cancer on biopsy 2. Of 203 men with persistent abnormalities 16 (8%) had cancer on biopsy 3 and 6 of 91 (7%) had cancer on biopsy 4 or later. Thus, 96% of the cancers were detected through either biopsy 1 or 2. The median initial PSA level, followup PSA levels and the yearly rate of change in PSA were significantly greater in men whose cancer was detected compared with those of men whose cancer was not detected (6.4 versus 5.4ng./ml., 7.4 versus 6.6ng./ml. and 1.1 versus 0.7ng./ml. per year, respectively). There was a trend for a higher percentage of tumors detected through serial screening to be pathologically organ confined compared with those detected through initial screening (73% versus 62%, p = 0.07). We conclude that men with a persistently elevated serum PSA value after an initial negative prostatic biopsy should routinely undergo at least 1 repeat biopsy to exclude adequately the presence of detectable prostate cancer. © 1994 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byAbraham N, Mendhiratta N and Taneja S (2014) Patterns of Repeat Prostate Biopsy in Contemporary Clinical PracticeJournal of Urology, VOL. 193, NO. 4, (1178-1184), Online publication date: 1-Apr-2015.Riedinger C, Womble P, Linsell S, Ye Z, Montie J, Miller D and Lane B (2014) Variation in Prostate Cancer Detection Rates in a Statewide Quality Improvement CollaborativeJournal of Urology, VOL. 192, NO. 2, (373-378), Online publication date: 1-Aug-2014.Vourganti S, Rastinehad A, Yerram N, Nix J, Volkin D, Hoang A, Turkbey B, Gupta G, Kruecker J, Linehan W, Choyke P, Wood B and Pinto P (2012) Multiparametric Magnetic Resonance Imaging and Ultrasound Fusion Biopsy Detect Prostate Cancer in Patients with Prior Negative Transrectal Ultrasound BiopsiesJournal of Urology, VOL. 188, NO. 6, (2152-2157), Online publication date: 1-Dec-2012.Hossack T, Patel M, Huo A, Brenner P, Yuen C, Spernat D, Mathews J, Haynes A, Sutherland R, del Prado W and Stricker P (2012) Location and Pathological Characteristics of Cancers in Radical Prostatectomy Specimens Identified by Transperineal Biopsy Compared to Transrectal BiopsyJournal of Urology, VOL. 188, NO. 3, (781-785), Online publication date: 1-Sep-2012.Kaplan S, Lee R, Chung D, Te A, Scherr D, Tewari A and Vaughan E (2012) Prostate Biopsy in Response to a Change in Nadir Prostate Specific Antigen of 0.4 ng/ml after Treatment with 5α-Reductase Inhibitors Markedly Enhances the Detection Rate of Prostate CancerJournal of Urology, VOL. 188, NO. 3, (757-761), Online publication date: 1-Sep-2012.Zaytoun O, Moussa A, Gao T, Fareed K and Jones J (2011) Office Based Transrectal Saturation Biopsy Improves Prostate Cancer Detection Compared to Extended Biopsy in the Repeat Biopsy PopulationJournal of Urology, VOL. 186, NO. 3, (850-854), Online publication date: 1-Sep-2011.de la Rosette J, Wink M, Mamoulakis C, Wondergem N, ten Kate F, Zwinderman K, de Reijke T and Wijkstra H (2009) Optimizing Prostate Cancer Detection: 8 Versus 12-Core Biopsy ProtocolJournal of Urology, VOL. 182, NO. 4, (1329-1336), Online publication date: 1-Oct-2009.Ching C, Moussa A, Li J, Lane B, Zippe C and Jones J (2009) Does Transrectal Ultrasound Probe Configuration Really Matter? 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(2018) EDITORIAL COMMENTJournal of Urology, VOL. 156, NO. 1, (120-120), Online publication date: 1-Jul-1996.Keetch D and Catalona W (2018) Prostatic Transition Zone Biopsies in Men with Previous Negative Biopsies and Persistently Elevated Serum Prostate Specific Antigen ValuesJournal of Urology, VOL. 154, NO. 5, (1795-1797), Online publication date: 1-Nov-1995.Smith D and Catalona W (2018) Rate of Change in Serum Prostate Specific Antigen Levels as a Method For Prostate Cancer DetectionJournal of Urology, VOL. 152, NO. 4, (1163-1167), Online publication date: 1-Oct-1994. Volume 151Issue 6June 1994Page: 1571-1574 Advertisement Copyright & Permissions© 1994 by The American Urological Association Education and Research, Inc.Keywordsprostatic neoplasmsantigens, neoplasmbiopsyMetrics Author Information David W. Keetch More articles by this author William J. Catalona More articles by this author Deborah S. Smith More articles by this author Expand All Advertisement PDF downloadLoading ...