(HealthDay News) — Men with negative biopsies during active surveillance for low-risk prostate cancer are more likely to have good long-term outcomes, according to a study published online in The Journal of Urology.

Carissa E. Chu, MD, from the University of California, San Francisco, and colleagues assessed the long-term clinical significance of consecutively negative biopsies among 514 men with low-risk prostate cancer undergoing active surveillance.

The researchers found that 22% of the men had 1 negative biopsy and 15% had consecutively negative biopsies. Among men with 1 negative biopsy and consecutively negative biopsies, the median prostate-specific antigen (PSA) density was lower versus men who never had a negative biopsy. Higher PSA density (odds ratio [OR], 1.68) and suspicious magnetic resonance imaging lesions (OR, 2.00) were associated with a higher likelihood of cancer being detected on the fourth biopsy. Furthermore, having 1 negative biopsy (OR, 0.22) and having consecutively negative biopsies (OR, 0.12) were associated with a lower likelihood of cancer being detected subsequently. Patients with consecutively negative biopsies (84%) and 1 negative biopsy (74%) had higher unadjusted 10-year treatment-free survival than those who had none (66%).

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“For men undergoing active surveillance, negative biopsies indicate low-volume disease and lower rates of disease progression,” Chu said in a statement. “These ‘hidden’ cancers have excellent long-term outcomes and remain ideal for continued active surveillance.”


Chu CE, Cowan JE, Fasulo V, et al. The clinical significance of multiple negative surveillance prostate biopsies for men on active surveillance—Does cancer vanish or simply hide? J Urol.