REPEAT SCREENING FOR PROSTATE CANCER AFTER 1-YEAR FOLLOWUP IN 984 BIOPSIED MEN: CLINICAL AND PATHOLOGICAL FEATURES OF DETECTED CANCER

No AccessJournal of UrologyClinical Urology: Original Articles1 Dec 1998REPEAT SCREENING FOR PROSTATE CANCER AFTER 1-YEAR FOLLOWUP IN 984 BIOPSIED MEN: CLINICAL AND PATHOLOGICAL FEATURES OF DETECTED CANCER JOHN B.W. RIETBERGEN, ARTO E. BOEKEN KRUGER, ROBERT F. HOEDEMAEKER, CHRIS H. BANGMA, WIM J. KIRKELS, and FRITZ H. SCHRODER JOHN B.W. RIETBERGENJOHN B.W. RIETBERGEN , ARTO E. BOEKEN KRUGERARTO E. BOEKEN KRUGER , ROBERT F. HOEDEMAEKERROBERT F. HOEDEMAEKER , CHRIS H. BANGMACHRIS H. BANGMA , WIM J. KIRKELSWIM J. KIRKELS , and FRITZ H. SCHRODERFRITZ H. SCHRODER View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)62256-0AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We describe the yield of a repeat examination and biopsy procedure 1 year after initial biopsy was negative. We also assessed the parameters responsible for the failure to diagnose these cancers at the primary screening. Materials and Methods: We screened 8,103 men randomized to the screening arm of the Rotterdam section of the European Randomized Study of Screening for Prostate Cancer using prostate specific antigen measurement, digital rectal examination and transrectal ultrasound. At the primary screening biopsy of 1,875 men was positive for prostate cancer in 374. Of the remaining 1,501 men 984 underwent repeat screening. Results: Biopsy at repeat screening diagnosed prostate cancer in 49 of 442 men (11%), a rate significantly lower than the 19.9% true positive biopsy rate at the primary screening. Pathological characteristics of the tumors diagnosed were not significantly different in the 2 groups. However, prostate volume in men diagnosed with prostate cancer was significantly greater at repeat versus primary screening (mean 42.6 versus 34.9 cc, p = 0.003). The clinical characteristics were more favorable because of an increased proportion of stage T1C tumors. Prostate volume in men with stage T1C cancer was significantly greater than in those with palpable or visible tumors in whom prostate specific antigen values were in the same range. Conclusions: The most important factor responsible for the failure to diagnose these cancers at the primary screening was significantly greater prostate volume. Tumor characteristics were not significantly different in the groups. If prostate cancer screening were to become a routine health care policy, efforts would have to be made to improve the chances of diagnosing prostate cancer in larger prostates by repeat biopsy or by increasing the number of cores obtained. References 1 : Clinical significance of repeat sextant biopsies in prostate cancer patients. Urology, suppl. 3A1997; 49: 113. Google Scholar 2 : The ability of systematic transrectal ultrasound guided biopsy to detect prostate cancer in men with the clinical diagnosis of benign prostatic hyperplasia. J. Urol.1991; 146: 75. Link, Google Scholar 3 : Random systematic versus directed ultrasound guided core biopsies of the prostate. J. Urol.1989; 142: 74. Google Scholar 4 : Systematic 5 region prostate biopsy is superior to sextant method for diagnosing carcinoma of the prostate. J. Urol.1997; 157: 199. Link, Google Scholar 5 : Serial prostatic biopsies in men with persistently elevated serum prostate specific antigen values. J. Urol.1994; 151: 1571. Link, Google Scholar 6 : Repeat prostate needle biopsy: who needs it? J. Urol.1995; 153: 1496. Abstract, Google Scholar 7 : Incidence of high-grade prostatic intraepithelial neoplasia in sextant needle biopsy specimens. Urology1997; 49: 367. Crossref, Medline, Google Scholar 8 : The incidence of high grade prostatic intraepithelial neoplasia in needle biopsies. J. Urol.1995; 154: 1791. Link, Google Scholar 9 : Transrectal ultrasound in the diagnosis of prostate cancer: location, echogenicity, histopathology, and staging. Prostate1985; 7: 117. Google Scholar 10 : Evaluation of prostate-specific antigen, digital rectal examination and transrectal ultrasonography in population-based screening for prostate cancer: improving the efficiency of early detection. Brit. J. Urol., suppl. 21997; 79: 57. Google Scholar 11 : The TNM classification of prostate cancer. Prostate1992; 4: 129. Crossref, Google Scholar 12 : Interexaminer variability of digital rectal examination in detecting prostate cancer. Urology1995; 45: 70. Crossref, Medline, Google Scholar 13 : The influence of prostate size on cancer detection. Urology1995; 46: 831. Crossref, Medline, Google Scholar 14 : Computer simulation of the probability of detecting low volume carcinoma of the prostate with six random systematic core biopsies. Urology1995; 45: 604. Google Scholar 15 : PSA-detected (clinical stage T1c or B0) prostate cancer. Pathologically significant tumors. Urol. Clin. N. Amer.1993; 20: 687. Google Scholar 16 : Radical prostatectomy for impalpable prostate cancer: the Johns Hopkins experience with tumors found on transurethral resection (stages T1A and T1B) and on needle biopsy (stage T1C). J. Urol., part 21994; 152: 1721. Abstract, Google Scholar 17 : Longitudinal evaluation of prostate-specific antigen levels in men with and without prostate disease. J.A.M.A.1992; 267: 2215. Google Scholar 18 : Natural history of changes in prostate specific antigen in early stage prostate cancer. J. Urol., part 21994; 152: 1743. Abstract, Google Scholar From the Departments of Urology and Pathology, Erasmus University and Academic Hospital, Rotterdam, The Netherlands© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byREMZI M, FONG Y, DOBROVITS M, ANAGNOSTOU T, SEITZ C, WALDERT M, HARIK M, MARIHART S, MARBERGER M and DJAVAN B (2018) THE VIENNA NOMOGRAM: VALIDATION OF A NOVEL BIOPSY STRATEGY DEFINING THE OPTIMAL NUMBER OF CORES BASED ON PATIENT AGE AND TOTAL PROSTATE VOLUMEJournal of Urology, VOL. 174, NO. 4 Part 1, (1256-1261), Online publication date: 1-Oct-2005.van der CRUIJSEN-KOETER I, VIS A, ROOBOL M, WILDHAGEN M, de KONING H, van der KWAST T and SCHRÖDER F (2018) COMPARISON OF SCREEN DETECTED AND CLINICALLY DIAGNOSED PROSTATE CANCER IN THE EUROPEAN RANDOMIZED STUDY OF SCREENING FOR PROSTATE CANCER, SECTION ROTTERDAMJournal of Urology, VOL. 174, NO. 1, (121-125), Online publication date: 1-Jul-2005.DJAVAN B, RAVERY V, ZLOTTA A, DOBRONSKI P, DOBROVITS M, FAKHARI M, SEITZ C, SUSANI M, BORKOWSKI A, BOCCON-GIBOD L, SCHULMAN C and MARBERGER M (2018) PROSPECTIVE EVALUATION OF PROSTATE CANCER DETECTED ON BIOPSIES 1, 2, 3 AND 4: WHEN SHOULD WE STOP?Journal of Urology, VOL. 166, NO. 5, (1679-1683), Online publication date: 1-Nov-2001.POTTS J (2018) PROSPECTIVE IDENTIFICATION OF NATIONAL INSTITUTES OF HEALTH CATEGORY IV PROSTATITIS IN MEN WITH ELEVATED PROSTATE SPECIFIC ANTIGENJournal of Urology, VOL. 164, NO. 5, (1550-1553), Online publication date: 1-Nov-2000.WEFER A, HRICAK H, VIGNERON D, COAKLEY F, LU Y, WEFER J, MUELLER-LISSE U, CARROLL P and KURHANEWICZ J (2018) SEXTANT LOCALIZATION OF PROSTATE CANCER: COMPARISON OF SEXTANT BIOPSY, MAGNETIC RESONANCE IMAGING AND MAGNETIC RESONANCE SPECTROSCOPIC IMAGING WITH STEP SECTION HISTOLOGYJournal of Urology, VOL. 164, NO. 2, (400-404), Online publication date: 1-Aug-2000.DJAVAN B, ZLOTTA A, REMZI M, GHAWIDEL K, BASHARKHAH A, SCHULMAN C and MARBERGER M (2018) OPTIMAL PREDICTORS OF PROSTATE CANCER ON REPEAT PROSTATE BIOPSY: A PROSPECTIVE STUDY OF 1,051 MENJournal of Urology, VOL. 163, NO. 4, (1144-1149), Online publication date: 1-Apr-2000. Volume 160Issue 6 Part 1December 1998Page: 2121-2125 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information JOHN B.W. RIETBERGEN More articles by this author ARTO E. BOEKEN KRUGER More articles by this author ROBERT F. HOEDEMAEKER More articles by this author CHRIS H. BANGMA More articles by this author WIM J. KIRKELS More articles by this author FRITZ H. SCHRODER More articles by this author Expand All Advertisement PDF downloadLoading ...