INTRODUCTION: An elevated PSA and a negative prostate biopsy (PB) can be a false negative PB that ignores a prostate cancer (PCa) or a false positive PSA not related to PCa.
The objective of this study was to analyze a group of patients who had a negative first BP for a PSA superior to 4ng/mL and at least one additional PB and to compare these cases with controls who had the diagnosis PCa from the first PB.
METHODS: Retrospective single-center study comparing patients with an elevated PSA and repeat biopsy following a first negative PB and patients with PCa diagnosed from the first PB.
RESULTS: The 63 cases were younger than the 75 controls and had more often a normal digital rectal examination. Their prostate volume was larger and their number of PSA before the first PB lower: this corresponded to a lower PSA in the second (7/64), third (6/31), fourth (3/9) and sixth (1/1) PB. Among these cases with PCa, the length of core invaded by cancer and the total length of cancer of the entire PB were smaller than controls. In 76% of cases, the Gleason score among cases was 6 or less.
CONCLUSION: PCa discovered on repeat biopsy had features of better prognosis than those of controls. We propose an algorithm for management of patients with elevated PSA and negative first PB.
Written by:
Floc'h AP, Benmeziani R, Delpech PO, Doré B, Fromont G, Irani J. Are you the author?
Service d'urologie, CHU de Poitiers, 86000 Poitiers, France.
Reference: Prog Urol. 2012 Oct;22(12):718-24.
doi: 10.1016/j.purol.2012.07.004
PubMed Abstract
PMID: 22999119
Article in French.
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