The risk of finding focal cancer (less than 3 mm) remains high on re-biopsy of patients with persistently increased prostate specific antigen but the clinical significance is questionable
(2004) In Journal of Urology 171(4). p.1500-1503- Abstract
- Purpose: We evaluated the significance of focal prostate cancer found in sextant biopsies in men participating in a biennial prostate specific antigen (PSA) based screening program. Materials and Methods: In 1995, 10,000 men 50 to 65 years old were randomized to biennial screening with PSA testing. Sextant biopsies were recommended when total PSA was 3 ng/ml or greater at screening rounds 1 and 2, and 2.54 ng/ml or greater at subsequent screening rounds. Focal cancer was defined as total a core cancer length of less than 3 mm in the biopsy specimen. Low volume cancer was defined as a total tumor volume of less than 0.5 cm(3) in the radical retropubic prostatectomy specimen. Results: The number of men who underwent biopsy and the number of... (More)
- Purpose: We evaluated the significance of focal prostate cancer found in sextant biopsies in men participating in a biennial prostate specific antigen (PSA) based screening program. Materials and Methods: In 1995, 10,000 men 50 to 65 years old were randomized to biennial screening with PSA testing. Sextant biopsies were recommended when total PSA was 3 ng/ml or greater at screening rounds 1 and 2, and 2.54 ng/ml or greater at subsequent screening rounds. Focal cancer was defined as total a core cancer length of less than 3 mm in the biopsy specimen. Low volume cancer was defined as a total tumor volume of less than 0.5 cm(3) in the radical retropubic prostatectomy specimen. Results: The number of men who underwent biopsy and the number of cancers detected in the 5 possible sets of biopsies were 1,725 and 402, 706 and 124, 307 and 36, 103 and 9, and 13 and 0, respectively. The risk of detecting focal cancer was 7.9%, 10.2%, 7.5%, 5.8% and 0%, respectively, but the relative ratio (focal-to-all cancers) increased 34%, 58%, 64%, 67% and, not applicable, respectively. In men with a total core cancer length of less than 10 mm there was no correlation between core cancer length and total tumor volume, as measured in the prostatectomy specimen. Two-thirds of men with a total core cancer length of less than 3 mm had a tumor volume of greater than 0.5 cm, while the risk of low volume cancer was less than 5% only in men with a total core cancer length of greater than 10 mm. Conclusions: In a repeat PSA based screening program sextant biopsies are of little or no value for predicting tumor volume. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/284564
- author
- Zackrisson, B ; Aus, G ; Bergdahl, S ; Lilja, Hans LU ; Lodding, P ; Pihl, CG and Hugosson, J
- organization
- publishing date
- 2004
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- screening, mass, prostatic neoplasms, prostate-specific antigen, prostate, biopsy
- in
- Journal of Urology
- volume
- 171
- issue
- 4
- pages
- 1500 - 1503
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- wos:000220361200026
- pmid:15017207
- scopus:1642365689
- ISSN
- 1527-3792
- DOI
- 10.1097/01.ju.0000118052.59597.83
- language
- English
- LU publication?
- yes
- id
- 60dabfce-ecc9-48c9-9d70-47353c54da6f (old id 284564)
- date added to LUP
- 2016-04-01 16:01:08
- date last changed
- 2022-04-30 18:21:08
@article{60dabfce-ecc9-48c9-9d70-47353c54da6f, abstract = {{Purpose: We evaluated the significance of focal prostate cancer found in sextant biopsies in men participating in a biennial prostate specific antigen (PSA) based screening program. Materials and Methods: In 1995, 10,000 men 50 to 65 years old were randomized to biennial screening with PSA testing. Sextant biopsies were recommended when total PSA was 3 ng/ml or greater at screening rounds 1 and 2, and 2.54 ng/ml or greater at subsequent screening rounds. Focal cancer was defined as total a core cancer length of less than 3 mm in the biopsy specimen. Low volume cancer was defined as a total tumor volume of less than 0.5 cm(3) in the radical retropubic prostatectomy specimen. Results: The number of men who underwent biopsy and the number of cancers detected in the 5 possible sets of biopsies were 1,725 and 402, 706 and 124, 307 and 36, 103 and 9, and 13 and 0, respectively. The risk of detecting focal cancer was 7.9%, 10.2%, 7.5%, 5.8% and 0%, respectively, but the relative ratio (focal-to-all cancers) increased 34%, 58%, 64%, 67% and, not applicable, respectively. In men with a total core cancer length of less than 10 mm there was no correlation between core cancer length and total tumor volume, as measured in the prostatectomy specimen. Two-thirds of men with a total core cancer length of less than 3 mm had a tumor volume of greater than 0.5 cm, while the risk of low volume cancer was less than 5% only in men with a total core cancer length of greater than 10 mm. Conclusions: In a repeat PSA based screening program sextant biopsies are of little or no value for predicting tumor volume.}}, author = {{Zackrisson, B and Aus, G and Bergdahl, S and Lilja, Hans and Lodding, P and Pihl, CG and Hugosson, J}}, issn = {{1527-3792}}, keywords = {{screening; mass; prostatic neoplasms; prostate-specific antigen; prostate; biopsy}}, language = {{eng}}, number = {{4}}, pages = {{1500--1503}}, publisher = {{Lippincott Williams & Wilkins}}, series = {{Journal of Urology}}, title = {{The risk of finding focal cancer (less than 3 mm) remains high on re-biopsy of patients with persistently increased prostate specific antigen but the clinical significance is questionable}}, url = {{http://dx.doi.org/10.1097/01.ju.0000118052.59597.83}}, doi = {{10.1097/01.ju.0000118052.59597.83}}, volume = {{171}}, year = {{2004}}, }