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Follow-up of men with elevated prostate-specific antigen and one set of benign biopsies at prostate cancer screening

Zackrisson, B; Aus, G; Lilja, Hans LU ; Lodding, P; Pihl, CG and Hugosson, J (2003) In European Urology 43(4). p.327-332
Abstract
Objective: To study the follow-up of men with elevated prostate-specific antigen (PSA) (>3 ng/ml) after one benign set of sextant biopsies. From the Goteborg branch of the European Randomised Study of Screening for Prostate Cancer (ERSPC). Method: 456 men with one set of benign sextant biopsies were followed every second year for 4 years with PSA determinations. In cases of elevated PSA, transrectal ultrasound (TRUS) guided sextant biopsies were suggested. Digital rectal examination (DRE), prostate volume, PSA, PSA density (PSAD) and the ratio between free and total PSA (PSA F/T) were recorded. Results: Complete data were available for 322 men. 3 groups were identified. In 84/322 (26%) men cancer was found ("cancer" group). 182/322... (More)
Objective: To study the follow-up of men with elevated prostate-specific antigen (PSA) (>3 ng/ml) after one benign set of sextant biopsies. From the Goteborg branch of the European Randomised Study of Screening for Prostate Cancer (ERSPC). Method: 456 men with one set of benign sextant biopsies were followed every second year for 4 years with PSA determinations. In cases of elevated PSA, transrectal ultrasound (TRUS) guided sextant biopsies were suggested. Digital rectal examination (DRE), prostate volume, PSA, PSA density (PSAD) and the ratio between free and total PSA (PSA F/T) were recorded. Results: Complete data were available for 322 men. 3 groups were identified. In 84/322 (26%) men cancer was found ("cancer" group). 182/322 (56%) had benign biopsies ("benign" group) and 56/322 (17%) had normalised PSA ("normalised PSA" group). Median prostate volumes were 36, 46, and 33 cc respectively in the three groups. DRE and/or TRUS were abnormal in only 30% of the men in all groups. Cancer was not found in any prostate >70 cc volume. In prostates of <20 cc either cancer was found or PSA was normalised. The "normalised PSA" group had initial PSA, PSAD and PSA F/T similar to cancer, normalising during follow-up. Conclusions: Patients with one negative sextant biopsy still have a high likelihood of cancer, especially men with persistently elevated PSA and small prostates (<20 cc) while the majority of men with large prostates (>70 cc) have PSA elevation due to benign prostate hyperplasia (BPH) and not to cancer. (C) 2003 Elsevier Science B.V. All rights reserved. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
re-biopsy, transrectal ultrasound (TRUS), PSA density, PSA (PSA ratio), free-to-total, prostate-specific antigen, screening, prostate, neoplasm
in
European Urology
volume
43
issue
4
pages
327 - 332
publisher
Elsevier
external identifiers
  • wos:000182417900001
  • pmid:12667711
  • scopus:0037390098
ISSN
1873-7560
DOI
10.1016/S0302-2838(03)00044-7
language
English
LU publication?
yes
id
d05be329-e5ba-4b3e-805f-d8385d423cba (old id 900457)
date added to LUP
2008-01-16 12:01:03
date last changed
2018-01-07 09:05:03
@article{d05be329-e5ba-4b3e-805f-d8385d423cba,
  abstract     = {Objective: To study the follow-up of men with elevated prostate-specific antigen (PSA) (&gt;3 ng/ml) after one benign set of sextant biopsies. From the Goteborg branch of the European Randomised Study of Screening for Prostate Cancer (ERSPC). Method: 456 men with one set of benign sextant biopsies were followed every second year for 4 years with PSA determinations. In cases of elevated PSA, transrectal ultrasound (TRUS) guided sextant biopsies were suggested. Digital rectal examination (DRE), prostate volume, PSA, PSA density (PSAD) and the ratio between free and total PSA (PSA F/T) were recorded. Results: Complete data were available for 322 men. 3 groups were identified. In 84/322 (26%) men cancer was found ("cancer" group). 182/322 (56%) had benign biopsies ("benign" group) and 56/322 (17%) had normalised PSA ("normalised PSA" group). Median prostate volumes were 36, 46, and 33 cc respectively in the three groups. DRE and/or TRUS were abnormal in only 30% of the men in all groups. Cancer was not found in any prostate &gt;70 cc volume. In prostates of &lt;20 cc either cancer was found or PSA was normalised. The "normalised PSA" group had initial PSA, PSAD and PSA F/T similar to cancer, normalising during follow-up. Conclusions: Patients with one negative sextant biopsy still have a high likelihood of cancer, especially men with persistently elevated PSA and small prostates (&lt;20 cc) while the majority of men with large prostates (&gt;70 cc) have PSA elevation due to benign prostate hyperplasia (BPH) and not to cancer. (C) 2003 Elsevier Science B.V. All rights reserved.},
  author       = {Zackrisson, B and Aus, G and Lilja, Hans and Lodding, P and Pihl, CG and Hugosson, J},
  issn         = {1873-7560},
  keyword      = {re-biopsy,transrectal ultrasound (TRUS),PSA density,PSA (PSA ratio),free-to-total,prostate-specific antigen,screening,prostate,neoplasm},
  language     = {eng},
  number       = {4},
  pages        = {327--332},
  publisher    = {Elsevier},
  series       = {European Urology},
  title        = {Follow-up of men with elevated prostate-specific antigen and one set of benign biopsies at prostate cancer screening},
  url          = {http://dx.doi.org/10.1016/S0302-2838(03)00044-7},
  volume       = {43},
  year         = {2003},
}