|The following article is part of conference coverage from the 2018 American Urological Association meeting in San Francisco. Renal and Urology News’ staff will be reporting live on medical studies conducted by urologists and other specialists who are tops in their field in kidney stones, prostate cancer, kidney cancer, bladder cancer, enlarged prostate, and more. Check back for the latest news from AUA 2018.|
SAN FRANCISCO—Negative confirmatory prostate biopsies in men on active surveillance for prostate cancer (PCa) are associated with a decreased risk of progression to treatment, study findings presented at the American Urological Association 2018 annual meeting suggest.
In a retrospective study of 974 men enrolled in AS from 1997 to 2014 with a minimum follow-up of 6 months, Keyan Salari, MD, and colleagues at Massachusetts General Hospital in Boston found that men who had a negative confirmatory biopsy had a significant 88% decreased risk of progression to treatment in multivariate analysis. Confirmatory biopsy status was not associated with the risk of adverse pathology on radical prostatectomy, metastasis-free survival, or disease-specific or overall survival.
At diagnosis, the men had a median age of 67 years and a median PSA level of 5.1 ng/mL. In addition, 97% had a Gleason score 6 or less and 92% had clinical stage T1 disease. After a median follow-up of 4.8 years, 702 men (72%) underwent a confirmatory biopsy. Of these biopsies, 67% were positive for PCa and 33% were negative.
Of the 702 patients, 33% progressed to treatment, with pathologic progression the reason in 77% of cases.
The authors concluded that a negative confirmatory biopsy “may serve as a useful tool for prognostication and help determine the need for further repeat biopsies for men on AS.”
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Salari K, Zlatev D, Kuppermann D, et al. The prognostic impact of a negative confirmatory biopsy in men on active surveillance for prostate cancer. Data presented in poster format at the American Urological Association 2018 annual meeting, San Francisco, May 18–21. Abstract MP17-14.