Korean J Urol.  2012 Oct;53(10):686-690. 10.4111/kju.2012.53.10.686.

The Prostate Cancer Detection Rate on the Second Prostate Biopsy according to Prostate-Specific Antigen Trend

• Kim HS
• Lee CY
• Lim DH
• Kim CS
• Baik S

• KMID: 1856987
• DOI: http://doi.org/10.4111/kju.2012.53.10.686

Abstract

PURPOSE
To identify the prostate cancer detection rate on the patients who had second prostate biopsy out of the patients who were reported negative in their first biopsy.
MATERIALS AND METHODS
From July 2006 to February 2012, prostate biopsy was performed on 843 patients with over 4 ng/ml and on 618 biopsy negative patients PSA was performed from between 6 months and 9 months after biopsy. On 164 patients, second biopsy was performed, and 42 patients were selected. If there was less than 10% change between PSA before the prostate biopsy and PSA measured during 6 to 9 months after the first biopsy it was considered as no change. If above 10% increase, it was considered increase and if above 10% decrease it was considered as decrease.
RESULTS
The cancer detection rate in PSA increase group was 20%, the detection rate in no change in PSA level but still over the normal range group 8.3%, and that in the PSA decrease group was 0%. When comparing prostate cancer group and non-cancer group, it is more probable to have prostate cancer when they are older, prostate volume is smaller and PSA density is higher.
CONCLUSIONS
The second biopsy is strongly recommended when PSA level shows no change or increase, age is older, prostate volume is smaller or PSA density is higher.

Keyword

Biopsy; Prostate; Prostate-specific antigen; Prostatic neoplasms

MeSH Terms

Biopsy
Humans
Prostate
Prostate-Specific Antigen
Prostatic Neoplasms
Reference Values
Prostate-Specific Antigen

Reference

1. Keetch DW, McMurtry JM, Smith DS, Andriole GL, Catalona WJ. Prostate specific antigen density versus prostate specific antigen slope as predictors of prostate cancer in men with initially negative prostatic biopsies. J Urol. 1996. 156(2 Pt 1):428–431.

2. Kakehi Y, Naito S. Japanese Urological Association. Complication rates of ultrasound-guided prostate biopsy: a nation-wide survey in Japan. Int J Urol. 2008. 15:319–321.

3. Noguchi M, Yahara J, Koga H, Nakashima O, Noda S. Necessity of repeat biopsies in men for suspected prostate cancer. Int J Urol. 1999. 6:7–12.

4. Durkan GC, Greene DR. Elevated serum prostate specific antigen levels in conjunction with an initial prostatic biopsy negative for carcinoma: who should undergo a repeat biopsy? BJU Int. 1999. 83:34–38.

5. Okada K, Okihara K, Kitamura K, Mikami K, Ukimura O, Kawauchi A, et al. Community-based prostate cancer screening in Japan: predicting factors for positive repeat biopsy. Int J Urol. 2010. 17:541–547.

6. Park EK, Yang WJ, Choi YD, Chung BH, Rha KH, Yang SC, et al. The significance of repeat prostate biopsy for the detection of prostate cancer. Korean J Urol. 2005. 46:1268–1271.

7. Antenor JA, Han M, Roehl KA, Nadler RB, Catalona WJ. Relationship between initial prostate specific antigen level and subsequent prostate cancer detection in a longitudinal screening study. J Urol. 2004. 172:90–93.

8. Bazinet M, Meshref AW, Trudel C, Aronson S, Peloquin F, Nachabe M, et al. Prospective evaluation of prostate-specific antigen density and systematic biopsies for early detection of prostatic carcinoma. Urology. 1994. 43:44–51.

9. Littrup PJ, Williams CR, Egglin TK, Kane RA. Determination of prostate volume with transrectal US for cancer screening Part. II. Accuracy of in vitro and in vivo techniques. Radiology. 1991. 179:49–53.

10. Hayek OR, Noble CB, de la Taille A, Bagiella E, Benson MC. The necessity of a second prostate biopsy cannot be predicted by PSA or PSA derivatives (density or free:total ratio) in men with prior negative prostatic biopsies. Curr Opin Urol. 1999. 9:371–375.

11. Stamey TA, Kabalin JN, McNeal JE, Johnstone IM, Freiha F, Redwine EA, et al. Prostate specific antigen in the diagnosis and treatment of adenocarcinoma of the prostate. II. Radical prostatectomy treated patients. J Urol. 1989. 141:1076–1083.

12. Carter HB, Pearson JD, Metter EJ, Brant LJ, Chan DW, Andres R, et al. Longitudinal evaluation of prostate-specific antigen levels in men with and without prostate disease. JAMA. 1992. 267:2215–2220.

13. Ito K, Yamamoto T, Ohi M, Kubota Y, Fukabori Y, Kurokawa K, et al. Usefulness of prostate-specific antigen velocity in screening for prostate cancer. Int J Urol. 2002. 9:316–321.

14. Paul R, Scholer S, van Randenborgh H, Kubler H, Alschibaja M, Busch R, et al. Morbidity of prostatic biopsy for different biopsy strategies: is there a relation to core number and sampling region? Eur Urol. 2004. 45:450–455.

15. Hollabaugh RS Jr, Dmochowski RR, Steiner MS. Neuroanatomy of the male rhabdosphincter. Urology. 1997. 49:426–434.

16. Soloway MS, Obek C. Periprostatic local anesthesia before ultrasound guided prostate biopsy. J Urol. 2000. 163:172–173.

17. Catalona WJ, Smith DS, Ratliff TL, Dodds KM, Coplen DE, Yuan JJ, et al. Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. N Engl J Med. 1991. 324:1156–1161.

18. Schmid HP, Riesen W, Prikler L. Update on screening for prostate cancer with prostate-specific antigen. Crit Rev Oncol Hematol. 2004. 50:71–78.

19. Catalona WJ, Ramos CG, Carvalhal GF, Yan Y. Lowering PSA cutoffs to enhance detection of curable prostate cancer. Urology. 2000. 55:791–795.

20. Vis AN, Kranse R, Roobol M, van der Kwast TH, Schroder FH. Serendipity in detecting disease in low prostate-specific antigen ranges. BJU Int. 2002. 89:384–389.

21. Cho JS, Kim SI, Kim SJ, Kim YS, Kim CI, Kim HS, et al. Lowering prostate-specific antigen threshold for prostate biopsy in Korean men: impact on the number needing biopsy. Korean J Urol. 2008. 49:118–121.

22. Postma R, Schroder FH. Screening for prostate cancer. Eur J Cancer. 2005. 41:825–833.

23. Oesterling JE, Cooner WH, Jacobsen SJ, Guess HA, Lieber MM. Influence of patient age on the serum PSA concentration. An important clinical observation. Urol Clin North Am. 1993. 20:671–680.

24. Oesterling JE, Jacobsen SJ, Chute CG, Guess HA, Girman CJ, Panser LA, et al. Serum prostate-specific antigen in a community-based population of healthy men. Establishment of age-specific reference ranges. JAMA. 1993. 270:860–864.

25. Jeon HJ, Kim YS, Kang DR, Nam CM, Kim CI, Seong DH, et al. Age-specific reference ranges for serum prostate-specific antigen in Korean men. Korean J Urol. 2006. 47:586–590.