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Atypical Small Acinar Proliferation and High Grade Prostatic Intraepithelial Neoplasia : Should We Be Concerned? An Observational Cohort Study with a Minimum Follow-Up of 3 Years. / Srirangam, Vinaya; Rai, Bhavan Prasad; Abroaf, Ahmed; Agarwal, Samita; Tadtayev, Sergey; Foley, Charlotte; Lane, Tim; Adshead, Jim; Vasdev, Nikhil.

In: Current Urology, Vol. 10, No. 4, 22.10.2017, p. 199-205.

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Srirangam, Vinaya ; Rai, Bhavan Prasad ; Abroaf, Ahmed ; Agarwal, Samita ; Tadtayev, Sergey ; Foley, Charlotte ; Lane, Tim ; Adshead, Jim ; Vasdev, Nikhil. / Atypical Small Acinar Proliferation and High Grade Prostatic Intraepithelial Neoplasia : Should We Be Concerned? An Observational Cohort Study with a Minimum Follow-Up of 3 Years. In: Current Urology. 2017 ; Vol. 10, No. 4. pp. 199-205.

Bibtex

@article{4baf2b7df93946bea9e020c3ab99640e,
title = "Atypical Small Acinar Proliferation and High Grade Prostatic Intraepithelial Neoplasia: Should We Be Concerned? An Observational Cohort Study with a Minimum Follow-Up of 3 Years",
abstract = "Introduction: Atypical small acinar proliferation (ASAP) and high grade prostatic intraepithelial neoplasia (HGPIN) are considered precancerous. We aimed to measure the rate of repeat biopsy and adenocarcinoma in patients with ASAP and HGPIN and identify any clinico-pathologic parameters at diagnosis of ASAP/HGPIN that are predictive of adenocarcinoma. Materials and Methods: Patients with a diagnosis of ASAP/HGPIN with no previous or concomitant cancer were identified. Prostate specific antigen (PSA) and magnetic resonance imaging (MRI) changes were monitored. Re-biopsy was at clinician discretion. Results: Nineteen were diagnosed with ASAP and 17 with HGPIN. Seven with ASAP (37%) and 6 with HGPIN (35%) underwent re-biopsy. Three (16%) with ASAP and 5 with HGPIN (29%) were diagnosed with adenocarcinoma. The difference in cancer detection rates between ASAP and HGPIN was not significant (p = 0.35). Five (14%) in total required definitive therapy for adenocarcinoma. Twenty-three (64%) did not undergo repeat biopsy. Parameters at diagnosis of HGPIN and ASAP, including PSA, prostate volume and PSA density, were compared between the cancer and non-cancer cohorts with none found to be predictive of adenocarcinoma. Conclusion: By monitoring PSA and MRI changes, we managed to spare re-biopsy in two-thirds of patients. Further evaluation is necessary to characterize a surveillance protocol in these populations.",
keywords = "Atypical small acinar proliferation, High grade prostatic intraepithelial neoplasia, Prostate biopsy, Prostatic adenocarcinoma",
author = "Vinaya Srirangam and Rai, {Bhavan Prasad} and Ahmed Abroaf and Samita Agarwal and Sergey Tadtayev and Charlotte Foley and Tim Lane and Jim Adshead and Nikhil Vasdev",
note = "{\textcopyright} 2016 S. Karger AG, Basel. ",
year = "2017",
month = oct,
day = "22",
doi = "10.1159/000447181",
language = "English",
volume = "10",
pages = "199--205",
journal = "Current Urology",
issn = "1661-7649",
publisher = "S. Karger AG",
number = "4",

}

RIS

TY - JOUR

T1 - Atypical Small Acinar Proliferation and High Grade Prostatic Intraepithelial Neoplasia

T2 - Should We Be Concerned? An Observational Cohort Study with a Minimum Follow-Up of 3 Years

AU - Srirangam, Vinaya

AU - Rai, Bhavan Prasad

AU - Abroaf, Ahmed

AU - Agarwal, Samita

AU - Tadtayev, Sergey

AU - Foley, Charlotte

AU - Lane, Tim

AU - Adshead, Jim

AU - Vasdev, Nikhil

N1 - © 2016 S. Karger AG, Basel.

PY - 2017/10/22

Y1 - 2017/10/22

N2 - Introduction: Atypical small acinar proliferation (ASAP) and high grade prostatic intraepithelial neoplasia (HGPIN) are considered precancerous. We aimed to measure the rate of repeat biopsy and adenocarcinoma in patients with ASAP and HGPIN and identify any clinico-pathologic parameters at diagnosis of ASAP/HGPIN that are predictive of adenocarcinoma. Materials and Methods: Patients with a diagnosis of ASAP/HGPIN with no previous or concomitant cancer were identified. Prostate specific antigen (PSA) and magnetic resonance imaging (MRI) changes were monitored. Re-biopsy was at clinician discretion. Results: Nineteen were diagnosed with ASAP and 17 with HGPIN. Seven with ASAP (37%) and 6 with HGPIN (35%) underwent re-biopsy. Three (16%) with ASAP and 5 with HGPIN (29%) were diagnosed with adenocarcinoma. The difference in cancer detection rates between ASAP and HGPIN was not significant (p = 0.35). Five (14%) in total required definitive therapy for adenocarcinoma. Twenty-three (64%) did not undergo repeat biopsy. Parameters at diagnosis of HGPIN and ASAP, including PSA, prostate volume and PSA density, were compared between the cancer and non-cancer cohorts with none found to be predictive of adenocarcinoma. Conclusion: By monitoring PSA and MRI changes, we managed to spare re-biopsy in two-thirds of patients. Further evaluation is necessary to characterize a surveillance protocol in these populations.

AB - Introduction: Atypical small acinar proliferation (ASAP) and high grade prostatic intraepithelial neoplasia (HGPIN) are considered precancerous. We aimed to measure the rate of repeat biopsy and adenocarcinoma in patients with ASAP and HGPIN and identify any clinico-pathologic parameters at diagnosis of ASAP/HGPIN that are predictive of adenocarcinoma. Materials and Methods: Patients with a diagnosis of ASAP/HGPIN with no previous or concomitant cancer were identified. Prostate specific antigen (PSA) and magnetic resonance imaging (MRI) changes were monitored. Re-biopsy was at clinician discretion. Results: Nineteen were diagnosed with ASAP and 17 with HGPIN. Seven with ASAP (37%) and 6 with HGPIN (35%) underwent re-biopsy. Three (16%) with ASAP and 5 with HGPIN (29%) were diagnosed with adenocarcinoma. The difference in cancer detection rates between ASAP and HGPIN was not significant (p = 0.35). Five (14%) in total required definitive therapy for adenocarcinoma. Twenty-three (64%) did not undergo repeat biopsy. Parameters at diagnosis of HGPIN and ASAP, including PSA, prostate volume and PSA density, were compared between the cancer and non-cancer cohorts with none found to be predictive of adenocarcinoma. Conclusion: By monitoring PSA and MRI changes, we managed to spare re-biopsy in two-thirds of patients. Further evaluation is necessary to characterize a surveillance protocol in these populations.

KW - Atypical small acinar proliferation

KW - High grade prostatic intraepithelial neoplasia

KW - Prostate biopsy

KW - Prostatic adenocarcinoma

UR - http://www.scopus.com/inward/record.url?scp=85034452054&partnerID=8YFLogxK

U2 - 10.1159/000447181

DO - 10.1159/000447181

M3 - Article

AN - SCOPUS:85034452054

VL - 10

SP - 199

EP - 205

JO - Current Urology

JF - Current Urology

SN - 1661-7649

IS - 4

ER -