A seven-year follow-up of men following a benign prostate biopsy.
OBJECTIVE
To determine the incidence and clinical relevance of newly diagnosed cases of prostate cancer in a group of men who had an elevated PSA and benign prostate biopsy 7 years previously.


METHODS
Patients under the age of 80 years with an elevated PSA who had had a benign prostate biopsy in the 12 months between March 1, 1994 and February 28, 1995 were studied. One hundred and sixty four patients with a mean age of 66.8 years (range 47-79 years) were identified. The mean PSA for this group was 10.3ng/ml (range 4.1-81ng/ml). One hundred and fifty nine of the 164 (97%) hospital records were available for review and all but 21 (12.8%) of the General Practitioners were contacted.


RESULTS
Eighteen (11%) of the original 164 patients were subsequently diagnosed with prostate cancer, 2 died from their disease.


CONCLUSIONS
In a population where the follow-up of patients with a benign biopsy was arranged on clinical grounds alone, 11% of the study group were diagnosed with prostate cancer during a seven-year follow-up. Although some of these cancers appear to be slow growing, most of those diagnosed in the initial follow-up period were deemed to be clinically significant and a small proportion progressed rapidly to metastases. All patients who have an elevated PSA, but benign biopsy, should undergo a period of PSA monitoring until it is clear that their PSA is not rising. We propose an initial intensive monitoring period to avoid missing those with clinically aggressive disease.
Boddy
Jane L
JL
Department of Urology, Royal Berkshire and Battle Hospitals, Oxford Road, Reading RG30 1AG, UK. boddyjane@hotmail.com
Pike
Derek J
DJ
Malone
Peter R
PR
D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000368:Aged; D001707:Biopsy, Needle; D015331:Cohort Studies; D005188:False Negative Reactions; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy / Q000379:methods; D011470:Prostatic Hyperplasia / Q000473:pathology / Q000601:surgery; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D018570:Risk Assessment; D013997:Time Factors; D020728:Transurethral Resection of Prostate / Q000379:methods
D017430:Prostate-Specific Antigen