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Factors include percent free PSA, maximum percent core involvement, PSA density, biopsy results

-- Eric Metcalf

Thursday, May 13, 2010 (Last Updated: 05/14/2010)

THURSDAY, May 13 (HealthDay News) -- Variables that are available at prostate cancer diagnosis and first surveillance biopsy during active surveillance can be used to inform men of the probability of an unfavorable biopsy, according to research published in the May issue of The Journal of Urology.

Kenneth S. Tseng, M.D., of the Johns Hopkins University School of Medicine in Baltimore, and colleagues analyzed data from 376 men with low-risk prostate cancer who were enrolled in an active surveillance program and underwent at least one follow-up biopsy after their diagnosis.

The researchers found that percent free prostate-specific antigen (PSA) and maximum percent core involvement at the diagnosis were linked to progression, which allowed for stratification of the risk of progression at initial surveillance biopsy. At this biopsy, the presence of cancer and PSA density (PSAD) were associated with later progression. The three-year probability of progression after the first surveillance biopsy was a cumulative incidence of 11.1 percent with negative biopsy and PSAD less than 0.08 ng/ml/cm3 versus 53.6 percent with positive biopsy and PSAD of 0.08 ng/ml/cm3 or higher.

"Briefly, in men with low-risk prostate cancer who are carefully selected for active surveillance it is possible to reclassify risk based on clinical features at diagnosis with further risk stratification based on the results of surveillance biopsy. This information could be used to counsel men who are considering active surveillance for newly diagnosed prostate cancer and reassure them or encourage curative intervention, depending on their risk aversion, after surveillance biopsy," the authors conclude.

Abstract
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Specialties Urology
Hematology & Oncology
Pathology
Family Practice
Internal Medicine

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