The association of atrophy in baseline prostate biopsy and lower prostate cancer grade in radical prostatectomy specimens.

To evaluate whether the presence of prostate atrophy (P.A.) in negative prostate biopsy is associated with prostate cancer (P.C.a) grade at surgical pathology among men who are ultimately diagnosed with P. C.a and undergo radical prostatectomy (R.P.).

A retrospective analysis was performed of 136 men from the placebo arm of the Reduction by Dutasteride of P.C.a Events (R.E.D.U.C.E.) trial who had a baseline prostate biopsy negative for P.C.a, and were later diagnosed with P.C.a on biopsy and underwent radical prostatectomy over the 4-year study period. The association of baseline P.A. (present/absent) with P.C.a grade (W.H.O./I.S.U.P. grade group 1 or ≥2) at surgical pathology was evaluated with logistic regression in uni- and multivariable analyses, controlling for baseline patient characteristics.

P.A. was observed in 74 prostate biopsies (54%). P.A. was not associated with baseline characteristics (age, body mass index, prostate-specific antigen level, prostate volume, race, family history of P.C.a, and digital rectal exam), except for chronic inflammation (p = 0.001). The presence of P.A. in baseline prostate biopsies was associated with lower risk of W.H.O./I.S.U.P. grade group ≥2 P.C.a in R.P. specimens on both univariable (O.R. = 0.39, 95% C.I. = 0.19-0.78, p = 0.008) and multivariable (O.R. = 0.43, 95% C.I. = 0.20-0.92, p = 0.029) analyses.

Among men with a baseline prostate biopsy negative for P.C.a who were later found to have P.C.a and underwent R.P., baseline P.A. is independently associated with lower risk of W.H.O./I.S.U.P. grade group ≥2 P.C.a on surgical pathology. P.A. may be used to identify subjects at lower risk for W.H.O./I.S.U.P. ≥ 2 P.C.a and select optimal candidates for active surveillance.

Scandinavian journal of urology. 2019 Feb 14 [Epub ahead of print]

D M O Freitas, G L Andriole, R Castro-Santamaria, S J Freedland, D M Moreira

a Department of Urology , Nossa Senhora da Conceição Hospital , Porto Alegre , Brazil., b Division of Urologic Surgery , Washington University School of Medicine , St. Louis , M.O. , U.S.A., c GlaxoSmithKline Inc., Global R&D , King of Prussia , Pennsylvania , P.A. , U.S.A., d Center for Integrated Research on Cancer and Lifestyle, Samuel Oschin Comprehensive Cancer Institute and the Division of Urology, Department of Surgery , Cedars-Sinai Medical Center , Los Angeles , C.A. , U.S.A., f Department of Urology , University of Illinois at Chicago , Chicago , I.L., U.S.A.

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