Does the Sextant Site of Atypical Small Acinar Proliferation on Initial Prostate Needle Biopsy Predict Sextant Site of Cancer on Follow-Up Prostate Needle Biopsy?
Jennifer L Merrimen, Glenn Jones, Adam Rocker, John R Srigley. Dalhousie University, Halifax, Canada; McMaster University, Hamilton, Canada; Mount Sinai Hospital, Toronto, Canada
Background: Prostate needle biopsies (PNBs) are routinely performed to evaluate patients with abnormal digital rectal exams or elevations in serum prostate specific antigens. A small percentage of cases show atypical small prostatic glandular proliferations (ASAP) and in these cases a repeat biopsy is recommended which yields a cancer diagnosis in 27-42% of cases.
Design: Using a database including data from the PNBs from 12304 men who underwent initial prostate sampling during an 8 year period (May 1999- June 2007), we identified 91 men who received an ASAP diagnosis and were found to have prostate cancer on a follow-up biopsy. Extended biopsy protocol strategies were reduced to traditional sextant sites. The site of ASAP on initial biopsy and site of cancer on follow-up biopsy were compared.
Results: In our study, the median duration between initial biopsy and follow-up biopsy with cancer diagnosis was 7.9 months. There is a significant correlation between the sextant site of an ASAP diagnosis and the sextant site of cancer in 43.4% (range 33.3-50%) of cases (p=0.014).
Conclusions: The sextant site of an ASAP on initial biopsy predicts the sextant site of cancer on follow-up biopsy in a moderate percentage of cases. The optimal repeat biopsy strategy in ASAP patients includes early, complete sampling of the prostate gland but additional samples from the sextant site of the ASAP may be useful in clarifying the diagnosis in these cases.
Category: Genitourinary (including renal tumors)
Wednesday, March 2, 2011 9:30 AM
Poster Session V # 72, Wednesday Morning