1942 BASELINE PROSTATE ATROPHY IS ASSOCIATED WITH REDUCED RISK OF PROSTATE CANCER IN MEN UNDERGOING REPEAT PROSTATE BIOPSY: RESULTS FROM THE REDUCE STUDY

You have accessJournal of UrologyProstate Cancer: Detection & Screening (III)1 Apr 20131942 BASELINE PROSTATE ATROPHY IS ASSOCIATED WITH REDUCED RISK OF PROSTATE CANCER IN MEN UNDERGOING REPEAT PROSTATE BIOPSY: RESULTS FROM THE REDUCE STUDY Daniel Moreira, J. Curtis Nickel, Leah Gerber, Roberto Muller, Gerald Andriole, Ramiro Castro-Santamaria, and Stephen Freedland Daniel MoreiraDaniel Moreira Manhasset, NY , J. Curtis NickelJ. Curtis Nickel Ontario, Canada , Leah GerberLeah Gerber Durham, NC , Roberto MullerRoberto Muller Durham, NC , Gerald AndrioleGerald Andriole Saint Louis, MO , Ramiro Castro-SantamariaRamiro Castro-Santamaria King of Prussia, PA , and Stephen FreedlandStephen Freedland Durham, NC View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2361AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Atrophy is a very common finding seen in prostates of patients undergoing biopsy. Notably, the clinical significance of prostatic atrophy in negative biopsies for prostate cancer (PCa) has been studied in a limited number of patients. Therefore, we evaluated whether presence and severity of baseline prostate atrophy among men with initial negative biopsy for PCa increased the risk of subsequent PCa detection in a clinical trial with systematic biopsies. METHODS Retrospective analysis of 5848 men 50-75 years-old with prostate-specific antigen (PSA) between 2.5-10ng/mL and a prior negative biopsy in the Reduction by Dutasteride of PCa Events (REDUCE) study who completed at least a 2-year biopsy. Patients previously on 5-alpha reductase inhibitors were excluded. PCa (defined as present or absent) and prostate atrophy (graded as absent, mild, moderate or marked) were assessed by central pathology review. The association of atrophy in baseline prostate biopsies with positive 2- and 4-year repeat biopsy was evaluated with logistic regression controlling for age, race, body-mass index (BMI), family history of PCa, digital rectal exam (DRE), prostate volume, pre-repeat biopsy PSA and treatment arm (dutasteride or placebo). RESULTS Prostate atrophy was detected in 4085 (69.5%) and graded as mild, moderate and marked in 3507 (59.7%), 573 (9.7%) and 5 (0.1%) baseline biopsies, respectively. Patients with atrophy at baseline were significantly older and had larger prostates (all P<0.01). Prostate atrophy was unrelated to race, BMI, family history of PCa, DRE, PSA and treatment arm. At 2-year biopsy, PCa prevalence was 15% (N=878). In univariable and multivariable analysis, presence of baseline prostate atrophy regardless of grade was significantly associated with lower PCa risk (OR=0.607; P<0.001 and OR=0.623; P<0.001, respectively). These results were virtually unchanged at 4-year biopsy. When stratified by severity, both mild and moderate atrophy were independently associated with lower risk of PCa in univariable (mild: OR=0.622; P<0.001 and moderate: OR=0.521; P<0.001) and multivariable analysis (mild: OR=0.639; P<0.001 and moderate: OR=0.536; P<0.001) at 2-year biopsy. Marked prostate atrophy was not analyzed due to low numbers. CONCLUSIONS In a cohort of men undergoing repeat prostate biopsy 2 and 4 years after negative baseline biopsy, baseline prostate atrophy was independently associated with lower PCa risk. Prostate atrophy in a negative biopsy for PCa may lower risk of PCa detection on repeat biopsy. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189 Issue 4S April 2013 Page: e796 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Metrics Author Information Daniel Moreira Manhasset, NY More articles by this author J. Curtis Nickel Ontario, Canada More articles by this author Leah Gerber Durham, NC More articles by this author Roberto Muller Durham, NC More articles by this author Gerald Andriole Saint Louis, MO More articles by this author Ramiro Castro-Santamaria King of Prussia, PA More articles by this author Stephen Freedland Durham, NC More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

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