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Active surveillance: Does serial prostate biopsy increase histological inflammation?
MedLine Citation:
PMID:  23318528     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background:Active surveillance (AS) is an appropriate management strategy for men with low-risk prostate cancer. Most protocols recommend repeated prostate biopsy every 12-24 months. The purpose of this paper is to describe histological inflammation patterns in men on AS who underwent serial prostate biopsy for disease monitoring.Methods:We reviewed records of men on AS from January 1999 through February 2011 who had a diagnostic plus 1 repeat transrectal ultrasound-guided biopsies performed at our institution. The type and degree of inflammatory infiltrate were grossly reviewed and scored for each patient's biopsy by a single pathologist. Relationship of inflammation severity and number of serial biopsies was assessed using a repeated measures mixed model. Unpaired t-test and χ(2)-square analysis assessed variance in degree of inflammation and location of inflammation relative to cancer grade progression defined as Gleason sum increase.Results:Fifty-six men met study inclusion criteria. Mean age was 62.1 (6.5) years, 71% were stage cT1c, 79% had a PSA level <10 ng ml(-1), and 98% had diagnostic Gleason sum 6. A small, statistically significant increase in maximum chronic inflammation (CI) scores with greater number of repeat biopsies was observed. CI scores were not associated with number of biopsies based on upgrade status. The main limitation to our study is our small sample size. Potential unmeasured confounders, such as unreported antibiotic use or symptomatic prostatitis, may have also affected our findings.Conclusions:In this pilot study of 56 men on AS for localized prostate cancer, degree of chronic histological inflammation increased with greater number of prostate biopsies, but was not associated with subsequent risk of grade progression.Prostate Cancer and Prostatic Disease advance online publication, 15 January 2013; doi:10.1038/pcan.2012.51.
Authors:
A S Glass; S P Porten; M Bonham; T C Tran; J E Cowan; S Punnen; J M Chan; P R Carroll
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-15
Journal Detail:
Title:  Prostate cancer and prostatic diseases     Volume:  -     ISSN:  1476-5608     ISO Abbreviation:  Prostate Cancer Prostatic Dis.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815755     Medline TA:  Prostate Cancer Prostatic Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Urology, University of California, San Francisco, CA, USA.
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