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.
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, 10000 men 50 to 65 years old were randomized to biennial screening with PSA testing....
| Main Authors: | , , , , , , |
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| Format: | Journal article |
| Language: | English |
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2004
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| _version_ | 1797103114588782592 |
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| author | Zackrisson, B Aus, G Bergdahl, S Lilja, H Lodding, P Pihl, C Hugosson, J |
| author_facet | Zackrisson, B Aus, G Bergdahl, S Lilja, H Lodding, P Pihl, C Hugosson, J |
| author_sort | Zackrisson, B |
| collection | OXFORD |
| description | 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, 10000 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 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 1725 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. |
| first_indexed | 2024-03-07T06:15:29Z |
| format | Journal article |
| id | oxford-uuid:f0f27c1f-7615-4eae-80ce-9bfc728dc616 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T06:15:29Z |
| publishDate | 2004 |
| record_format | dspace |
| spelling | oxford-uuid:f0f27c1f-7615-4eae-80ce-9bfc728dc6162022-03-27T11:52:02ZThe 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.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f0f27c1f-7615-4eae-80ce-9bfc728dc616EnglishSymplectic Elements at Oxford2004Zackrisson, BAus, GBergdahl, SLilja, HLodding, PPihl, CHugosson, J 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, 10000 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 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 1725 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. |
| spellingShingle | Zackrisson, B Aus, G Bergdahl, S Lilja, H Lodding, P Pihl, C Hugosson, J 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. |
| 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. |
| title_full | 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. |
| title_fullStr | 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. |
| title_full_unstemmed | 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. |
| title_short | 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. |
| title_sort | 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 |
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