new YORK (Reuters Health) – A study of the clinic
Cleveland in United States shows that the majority of the
prostate cancers detected after more than two biopsies
are clinically irrelevant.
“The risk to detect clinically insignificant cancers
“”
moderates the enthusiasm for the biopsy in series”, says the team
the doctor Osama M. Zaytoun.
At BJU International, the authors write that the majority of
prostate cancers of detected in the first biopsy or
after the second, but that “the continued suspicion of cancer
“”
sometimes leads to a serial biopsy done”.
Even so, the detection rate decreases with the amount of
repeated biopsies. The same would happen with the clinical relevance
detected cancers.
Outcomes arise from 479 men who are les
they carried out 749 biopsies repeated after two results
negative. The protocols used included schemes
extended with 10-14 samples or saturation more protocols
of 20 samples.
They detected cancer 119 patients (24.8 per cent),
but 75 positive results (63 per cent) were
clinically insignificant cancers (lower Gleason score
3, not more than three positive samples and tumor tissue in not
more than 50 percent of the positive sample).
Team concludes that the threshold for repeat biopsy
it should be “very high” after more than one negative, result
taking into account the possibility of detecting cancer
clinically insignificant, versus the risk of overlooking
clinically relevant tumors.
For this reason, the authors point out that “patients with a
“
clear indication of serial biopsy are those
with proliferation of atypical small acinos (ASAP, for their
acronym in English) or with prostatic intraepithelial neoplasia of
high degree (HPGIN) within a protocol biopsies with
“
delayed intervals”.
On the other hand, “in patients with benign findings are
“
should avoid future biopsies serial in the absence of a
significant change of clinical suspicion, including the
variations of outcomes of rectal, increased to the
double the level of prostate-specific antigen (PSA) or the
marked reduction in the percentage of free/total PSA (fPSA %) “.
“
Source: BJU International, 2012
