|
Asian Journal of Andrology (2013) 15, 236β240; doi:10.1038/aja.2012.123; published online 31 December 2012
Detection rate of clinically insignificant prostate cancer increases with repeat prostate biopsies
Bumsoo Park1,2,3, Seong-Soo Jeon1,2, Sung-Ho Ju1, Byong-Chang Jeong1,2, Seong-Il Seo1,2, Hyun-Moo Lee1,2 and Han-Yong Choi1
1 Department of Urology, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea
2 Institute for Refractory Cancer Research, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea
3 Department of Urology, Kangnam General Hospital, Yongin 446-597, Korea
Correspondence: Dr SS Jeon, (seongsoo.jeon@samsung.com)
Received 13 May 2012; Revised 24 August 2012; Accepted 26 September 2012
Advance online publication 31 December 2012
| Abstract |
To analyze if clinically insignificant prostate cancer (CIPC) is more frequently detected with repeat prostate biopsies, we retrospectively analyzed the records of 2146 men diagnosed with prostate cancer after one or more prostate biopsies. The patients were divided into five groups according to the number of prostate biopsies obtained, e.g. group 1 had one biopsy, group 2 had two biopsies and group 3 had three biopsies. Of the 2146 patients diagnosed with prostate cancer, 1956 (91.1%), 142 (6.6%), 38 (1.8%), 9 (0.4%) and 1 (0.1%) men were in groups 1, 2, 3, 4 and 5, respectively. Groups 4 and 5 were excluded because of the small sample sizes. The remaining three groups (groups 1, 2 and 3) were statistically analyzed. There were no differences in age or prostate-specific antigen level among the three groups. CIPC was detected in 201 (10.3%), 28 (19.7%) and 9 (23.7%) patients in groups 1, 2 and 3, respectively (P<0.001). A multivariate analysis showed that the number of biopsies was an independent predictor to detect CIPC (OR=2.688 for group 2; OR=4.723 for group 3). In conclusion, patients undergoing multiple prostate biopsies are more likely to be diagnosed with CIPC than those who only undergo one biopsy. However, the risk still exists that the patient could have clinically significant prostate cancer. Therefore, when counseling patients with regard to serial repeat biopsies, the possibility of prostate cancer overdiagnosis and overtreatment must be balanced with the continued risk of clinically significant disease.
Keywords: clinically insignificant prostate cancer (CIPC); clinically significant prostate cancer (CSPC); biopsy; early detection of cancer; prostatic neoplasms |
|
