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Clinical Research

Prostate atypia: clinical and pathological variables associated with cancer diagnosis on repeat biopsy

Prostate Cancer and Prostatic Diseases volume 14, pages 149–154 (2011)Cite this article

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Abstract

The clinical significance of atypical glands suspicious for malignancy (atypia) on prostate biopsy is unclear. We studied a cohort of 139 patients with atypia who underwent repeat prostate biopsy. We analyzed clinical and pathological variables that may be associated with cancer on repeat biopsy. Cancer was diagnosed in 41 (29%) of patients with atypia: 26 of 41 (66%) were Gleason 6, 20% were Gleason 7 and 7% were Gleason 8 (Gleason <6 not reported). There were no significant associations of age, race, family history, PSA, PSA density (PSAd), number of previous biopsies or time to repeat biopsy with cancer diagnosis. In multivariate regression, histological inflammation was associated with an 85% decreased probability of cancer on repeat biopsy (odds ratio; OR 0.15; 95% confidence interval; CI 0.04–0.57; P=0.04). Radical prostatectomy was performed in 14 of 41 (34%) patients with cancer; 6 (43%) were Gleason sum ⩾7, 3 (21%) were pT3a and 1 (7%) had lymph node metastases. In conclusion, inflammation was independently associated with a significantly decreased risk of cancer on repeat biopsy. However, some patients with initial atypia have higher-risk prostate cancer. Additional studies are needed to elucidate these associations.

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Author notes

  1. J L Silberstein

    Present address: 5Current address: Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA,

Authors and Affiliations

  1. Division of Urology, Department of Surgery, University of California San Diego, San Diego, CA, USA

    R P Kopp, J K Parsons, J Shiau, J L Silberstein, I H Derweesh & K Sakamoto

  2. Moores UCSD Cancer Center, La Jolla, CA, USA

    J K Parsons, K Palazzi-Churas & I H Derweesh

  3. VA San Diego Medical Center, La Jolla, CA, USA

    J K Parsons, I H Derweesh & K Sakamoto

  4. Department of Pathology, University of California San Diego, San Diego, CA, USA

    J Wang-Rodriguez

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  1. R P Kopp
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Correspondence to K Sakamoto.

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Competing interests

Dr Parsons receives compensation as consultant for AMS and as an investor of Urigen. Dr Kopp, Mr Shiau, Dr Wang-Rodriguez, Ms Palazzi-Churas, Dr Silberstein, Dr Derweesh, and Dr Sakamoto declare no conflict of interest.

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Kopp, R., Parsons, J., Shiau, J. et al. Prostate atypia: clinical and pathological variables associated with cancer diagnosis on repeat biopsy. Prostate Cancer Prostatic Dis 14, 149–154 (2011). https://doi.org/10.1038/pcan.2010.53

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