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- W2006190057 abstract "No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Sep 2001REPEAT BIOPSY STRATEGY IN PATIENTS WITH ATYPICAL SMALL ACINAR PROLIFERATION OR HIGH GRADE PROSTATIC INTRAEPITHELIAL NEOPLASIA ON INITIAL PROSTATE NEEDLE BIOPSY Prodromos G. Borboroglu, Roger L. Sur, James L. Roberts, and Christopher L. Amling Prodromos G. BorborogluProdromos G. Borboroglu More articles by this author , Roger L. SurRoger L. Sur More articles by this author , James L. RobertsJames L. Roberts More articles by this author , and Christopher L. AmlingChristopher L. Amling More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)65853-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Isolated high grade prostatic intraepithelial neoplasia and/or atypical small acinar proliferation on prostate biopsy increases the risk of identifying cancer on repeat biopsy. We report the results of repeat prostate biopsy for high grade prostatic intraepithelial neoplasia and/or atypical small acinar proliferation, and propose an optimal repeat biopsy strategy. Materials and Methods: Of 1,391 men who underwent standard systematic sextant biopsy of the prostate 137 (9.8%) had isolated high grade prostatic intraepithelial neoplasia or atypical small acinar proliferation, including 100 who underwent repeat prostate biopsy within 12 months of the initial biopsy. Results: Adenocarcinoma was detected in 47 of the 100 patients who underwent repeat biopsy. The initial biopsy site of high grade prostatic intraepithelial neoplasia and/or atypical small acinar proliferation matched the sextant location of cancer on repeat biopsy in 22 cases (47%). Repeat biopsy directed only to the high grade prostatic intraepithelial neoplasia and/or atypical small acinar proliferation site on initial biopsy would have missed 53% of cancer cases. In 12 of the 47 men (26%) cancer was limited to the side of the prostate contralateral to the side of high grade prostatic intraepithelial neoplasia and/or atypical small acinar proliferation. Of the 31 patients with cancer in whom the transition zone was sampled cancer was limited to the transition zone in 4 (13%) and evident at other biopsy sites in 13 (42%). The only significant predictor of positive repeat biopsy was mean prostate specific antigen velocity plus or minus standard error (1.37 ± 1.4 versus 0.52 ± 0.8 ng./ml. per year, p <0.001). Conclusions: Patients with isolated high grade prostatic intraepithelial neoplasia and/or atypical small acinar proliferation on prostate biopsy are at 47% risk for cancer on repeat biopsy. The optimal repeat biopsy strategy in this setting should include bilateral biopsies of the standard sextant locations. We also strongly recommend that transition zone sampling should be considered. References 1 : Morphogenesis of prostatic carcinoma. Cancer1965; 18: 1659. Google Scholar 2 : Intraductal dysplasia: a premalignant lesion of the prostate. Hum Pathol1986; 17: 64. Google Scholar 3 : Prostatic intra-epithelial neoplasia and early invasion in prostate cancer. Cancer1987; 59: 788. 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J Urol1995; 154: 1295. Link, Google Scholar 17 : The focus of “atypical glands suspicious for malignancy” in prostate needle biopsy specimens: incidence, histologic features, and clinical follow-up of cases diagnosed in a community practice. Am J Clin Pathol1997; 108: 633. Google Scholar 18 : Strategy for repeat biopsy of patients with prostatic intraepithelial neoplasia detected by prostate needle biopsy. J Urol1996; 155: 228. Link, Google Scholar 19 : Repeat biopsy strategy in men with isolated prostatic intraepithelial neoplasia on prostate needle biopsy. J Urol1996; 156: 460. Link, Google Scholar 20 : Random systematic versus directed ultrasound guided transrectal core biopsies of the prostate. J Urol1989; 142: 71. Abstract, Google Scholar 21 : Extensive repeat transrectal ultrasound guided prostate biopsy in patients with previous benign sextant biopsies. J Urol2000; 163: 158. 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Google Scholar From the Department of Urology, Naval Medical Center San Diego, San Diego, California© 2001 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited ByMerrimen J, Jones G, Hussein S, Leung C, Kapusta L and Srigley J (2018) A Model to Predict Prostate Cancer After Atypical Findings in Initial Prostate Needle BiopsyJournal of Urology, VOL. 185, NO. 4, (1240-1245), Online publication date: 1-Apr-2011.Merrimen J, Jones G, Walker D, Leung C, Kapusta L and Srigley J (2018) Multifocal High Grade Prostatic Intraepithelial Neoplasia is a Significant Risk Factor for Prostatic AdenocarcinomaJournal of Urology, VOL. 182, NO. 2, (485-490), Online publication date: 1-Aug-2009.Abouassaly R, Tan N, Moussa A and Jones J (2018) Risk of Prostate Cancer After Diagnosis of Atypical Glands Suspicious for Carcinoma on Saturation and Traditional BiopsiesJournal of Urology, VOL. 180, NO. 3, (911-914), Online publication date: 1-Sep-2008.Epstein J and Herawi M (2018) Prostate Needle Biopsies Containing Prostatic Intraepithelial Neoplasia or Atypical Foci Suspicious for Carcinoma: Implications for Patient CareJournal of Urology, VOL. 175, NO. 3, (820-834), Online publication date: 1-Mar-2006.Girasole C, Cookson M, Putzi M, Chang S, Smith J, Wells N, Oppenheimer J and Shappell S (2018) Significance of Atypical and Suspicious Small Acinar Proliferations, and High Grade Prostatic Intraepithelial Neoplasia on Prostate Biopsy: Implications for Cancer Detection and Biopsy StrategyJournal of Urology, VOL. 175, NO. 3, (929-933), Online publication date: 1-Mar-2006.Yanke B, Salzhauer E and Colon I (2018) Is Race a Positive Predictor of Cancer on Repeat Prostate Biopsy?Journal of Urology, VOL. 176, NO. 3, (1114-1117), Online publication date: 1-Sep-2006.UNG J, SAN FRANCISCO I, REGAN M, DeWOLF W and OLUMI A (2018) The Relationship of Prostate Gland Volume to Extended Needle Biopsy on Prostate Cancer DetectionJournal of Urology, VOL. 169, NO. 1, (130-135), Online publication date: 1-Jan-2003.Lefkowitz G, Taneja S, Brown J, Melamed J and Lepor H (2018) Followup Interval Prostate Biopsy 3 Years After Diagnosis of High Grade Prostatic Intraepithelial Neoplasia is Associated With High Likelihood of Prostate Cancer, Independent of Change in Prostate Specific Antigen LevelsJournal of Urology, VOL. 168, NO. 4 Part 1, (1415-1418), Online publication date: 1-Oct-2002. Volume 166Issue 3September 2001Page: 866-870 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.Keywordsprostatic intraepithelial neoplasiabiopsyprostatic neoplasmsprostateMetricsAuthor Information Prodromos G. Borboroglu More articles by this author Roger L. Sur More articles by this author James L. Roberts More articles by this author Christopher L. Amling More articles by this author Expand All Advertisement PDF DownloadLoading ..." @default.
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