Men with a relatively low PSA level and normal results from an initial prostate biopsy rarely harbor lethal prostate cancer (PCa), according to findings presented at the European Society for Medical Oncology 2016 congress in Copenhagen.
Nina Klemann, MD, and colleagues at Copenhagen University Hospital analyzed data from 64,430 men in the Danish Prostate Cancer Register who were referred for their first transurethral ultrasound-guided prostate biopsy from 1995 to 2011. Of these, 27,537 had benign first biopsy results. The median follow-up was 7.1 years.
With up to 20 years of follow-up, the estimated cumulative incidence of PCa mortality and other-cause mortality was 25.6% and 50.5%, respectively, for the entire cohort and 5.2% and 59.9%, respectively, for men with initial benign findings, Dr Klemann’s group reported.
When stratified by PSA level at the time of referral for biopsy, the estimated risk of PCa mortality after 15 years in men with a benign first biopsy was 0.7% for a PSA level of 10 ng/mL or less, 3.6% for a PSA level greater than 10 but not more than 20 ng/mL, and 17.6% for a PSA level greater than 20 ng/mL.
“This information has implications for the future strategy of how to advise men with benign biopsies,” the investigators concluded.
1. Klemann N et al. Risk of prostate cancer mortality in men with an initial benign needle core biopsy set: a population based analysis with up to 20 years of follow-up. Data presented at the European Society for Medical Oncology 2016 congress in Copenhagen, Denmark, October 7–11, 2016. Poster 724PD.