Transcript Prostate Cancer Detection in Men with an Initial Diagnosis

Prostate Cancer Detection in Men
with an Initial Diagnosis of Atypical
small Acinar Proliferations
Dr Charles Chabert
The Wollongong Hospital
Definition
ASAP denotes the presence of
suspicious glands with insufficient
cytological or architectural atypia for
a definitive cancer diagnosis
Bostwick et al Hum Path.1993; 24:819
Objective
Determine the clinical significance of
ASAP in prostate biopsies
Methods
Illawarra prostate pathology data base
reviewed
Jan 1994- Jan 2004
ASAP
Pathology reviewed
Clinical records obtained
Method
Study cohort 31
Median age: 65 years (53-78 years)
Median PSA: 7.6ng/ml (0.3-36ng/ml)
Results
ASAP 31
22
Second Biopsy
9
No further
Biopsy
Results of No Repeat
Biopsy
9
No repeat biopsy
TURP: 1
Benign
Median F/U: 8
78 months
1 CAP
Results
ASAP 31
9
No further
Biopsy
22
Second Biopsy
Results of 2nd Biopsy
ASAP
22/31
Benign 4
ASAP 5
Prostate cancer 13
Median interval between 1st & 2nd biopsy
8 Months
Prostate Ca in 2nd Biopsy
3+4=7
(5)
4+4=8
(3)
13/22
Prostate
Cancer
3+3=6
(2)
4+5=9
(1)
4+3=7
(2)
Results of 2nd Biopsy
ASAP
22/31
Prostate cancer 13
Benign 4
ASAP 5
Results of 3rd Biopsy
ASAP
5
All Biopsied
Prostate Ca 2
Benign 2
ASAP 1
Median interval between 2nd & 3rd
14 months
Results of 2nd Biopsy
ASAP
22/31
Benign 4
Prostate cancer 13
ASAP 5
Results of 3rd Biopsy
Benign:
4
Benign 2
ASAP 1
CAP
4+3=7
Summary
Subsequent CAP detection
17/31
54.8 %
ASAP diagnosis mandates rebiopsy
Acknowledgement
Dr Sabar Napaki,
Southern Pathology, Wollongong
High•Grade PIN
ASAP