Abstract
Background
African American (AA) men are known to have more aggressive prostate cancer (PCa)
compared with Caucasian American men. We sought to determine predictors of subsequent
detection and risk stratification of PCa in a racially diverse group of men with atypical
small acinar proliferation (ASAP) on initial prostate biopsy.
Materials and Methods
A retrospective analysis was conducted on data from men with ASAP on initial prostate
biopsy who subsequently received confirmatory biopsies between September 2000 and
July 2015. Biopsies with more than 3 years between initial and confirmatory biopsies
were excluded. Race, age, body mass index, transrectal ultrasound volume, serum prostate-specific
antigen (PSA), PSA velocity, PSA density, and elapsed time between biopsies were assessed
for predictive value in subsequent PCa diagnosis after an initial finding of ASAP.
Results
Of 106 men analyzed, 75 (71%) were AA and 31 (29%) were non-AA. Baseline variables
revealed AA men had higher PSA levels, PSA velocity, and PSA density (all P < .05). PCa was diagnosed in subsequent biopsy in 42 (40%) patients without significant
racial variation; 30 (40%) AA versus 12 (39%) non-AA. Of the 42 PCa patients, 25 (24%)
met Epstein criteria for significant disease without racial variation; 18 (24%) AA
versus 7 (23%) non-AA. Only 10 (9%) patients had any component of Gleason 4; 7 (9%)
AA versus 3 (10%) non-AA. In multivariate analysis, increasing age, PSA level, and
PSA density were significant predictors of PCa.
Conclusion
AA men diagnosed with ASAP on initial prostate biopsy do not have increased risk of
PCa on confirmatory biopsy compared with non-AA men.
Keywords
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Article info
Publication history
Published online: April 25, 2017
Accepted:
April 14,
2017
Received in revised form:
April 6,
2017
Received:
March 10,
2017
Footnotes
R.S.L. and J.J.K. are both considered first authors.
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
