title: Management of men with a suspicion of prostate cancer after negative initial prostate biopsy results.
abstract: BACKGROUND
  For men with elevated prostate-specific antigen (PSA), appropriate management after negative prostate biopsy remains controversial. After determining PSA kinetics, subsequent follow-up was considered.
  
  
  METHODS
  A total of 115 cases with negative repeat biopsy were followed by evaluating PSA kinetics and ratio of percent free PSA (F/T) and by performing second repeat biopsy.
  
  
  RESULTS
  Eighteen cancer cases were diagnosed. Shorter PSA doubling times and faster velocities were found in cancer cases compared with cases without cancer. We observed a clear decrease in F/T among cancer cases.
  
  
  CONCLUSIONS
  To avoid unnecessary repeat biopsies, cases with a suspicion of cancer after negative biopsy can be divided into two groups: one that requires additional biopsies and one with an average change in PSA of <1 ng/ml/year and no change in F/T, which is recommended for surveillance as stable disease without biopsy over a specified time period.
authors.affiliation: Department of Urology, Asahi General Hospital, Asahi, Japan.
authors.forename: Sachi
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Mayuko
authors.initials: M
authors.lastname: Kato
authors.forename: Yuusuke
authors.initials: Y
authors.lastname: Tomiyama
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Amiya
authors.forename: Makoto
authors.initials: M
authors.lastname: Sasaki
authors.forename: Takayuki
authors.initials: T
authors.lastname: Shima
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Suzuki
authors.forename: Shino
authors.initials: S
authors.lastname: Murakami
authors.forename: Hiroomi
authors.initials: H
authors.lastname: Nakatsu
authors.forename: Jun
authors.initials: J
authors.lastname: Shimazaki
mesh_terms: D000368:Aged; D001706:Biopsy; D018450:Disease Progression; D055088:Early Detection of Cancer; D006801:Humans; D007610:Kallikreins / Q000097:blood; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000628:therapy*; D013997:Time Factors; D015854:Up-Regulation
chemical_list: C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen