Extent of Baseline Prostate Atrophy Is Associated With Lower Incidence of Low- and High-grade Prostate Cancer on Repeat Biopsy.pdf (160.92 kB)
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Extent of Baseline Prostate Atrophy Is Associated With Lower Incidence of Low- and High-grade Prostate Cancer on Repeat Biopsy

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posted on 11.12.2017, 00:00 authored by D.M. Freitas, Gerald L. Andriole, R. Castro-Santamaria, S.J. Freedland, D.M. Moreira
Objective: To evaluate whether baseline prostate atrophy (PA) extent is associated with prostate cancer (PCa) incidence at 2-year repeat prostate biopsy in a clinical trial with systematic biopsies. Materials and Methods: We performed a retrospective analysis of 3165 men 50-75 years old with prostate-specific antigen between 2.5 and 10 ng/mL and a prior negative biopsy in the placebo arm of the Reduction by Dutasteride of PCa Events trial who underwent a 2-year repeat biopsy. PA extent was defined as the percentage of cores with atrophic changes. The association of baseline PA with positive 2-year biopsies was evaluated with logistic regression in uni- and multivariable analysis, controlling for baseline covariates. Results: PA involving none, 1%-25%, 26%-50%, 51%-75%, and >75% of the baseline cores was observed in 966 of 3165 (30.5%), 1189 of 3165 (37.6%), 677 of 3165 (21.4%), 209 of 3165(6.6%), and 124 of 3165 (3.9%) cases, respectively. More extensive PA was associated with older age, lower prostate-specific antigen, larger prostate volume, and higher prevalence of acute and chronic inflammations (all P < .05). Compared to subjects without PA, those with 1%-25%, 26%-50%, 51%-75%, and >75% core involvement had an odds ratio for PCa of 0.65 (95% confidence interval [CI] = 0.52-0.81), 0.60 (95% CI = 0.46-0.78), 0.56 (95% CI = 0.37-0.86), and 0.35 (95% CI = 0.19-0.67), respectively. In multivariable analysis, the extent of PA was independently associated with lower PCa risk (P < .001). More extensive PA was associated with lower incidence of low-grade (Gleason 2-6) and high-grade (Gleason 7-10) PCa. Conclusion: The extent of baseline PA is independently associated with lower PCa risk in a dose-dependent fashion.

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NOTICE: This is the author’s version of a work that was accepted for publication in Urology. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Urology, 11/22/2016, DOI: 10.1016/j.urology.2016.12.027

Publisher

Elsevier

issn

00904295

Issue date

22/11/2016

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