Login to Access Video or Poster Abstract: MP20-07
Sources of Funding: None

Introduction

Prostate atrophy (PA) is a common histological finding in prostate biopsy specimens. It is known to mimic prostate cancer (PCa) on imaging and histology. Recent data suggest PA in a negative biopsy is associated with lower risk of PCa detection in subsequent biopsies, and lower risk of high-grade PCa in men who are eventually diagnosed with PCa. However, the association of PA in prostate biopsies with PCa grade in radical prostatectomy (RP) specimens has not been studied in earnest. Therefore, the objective of this study is to evaluate whether the presence of PA in a baseline prostate biopsies negative for PCa is associated with PCa grade in the surgical specimen among patients eventually diagnosed with PCa undergoing RP.

Methods

We performed a retrospective analysis of 137 men, 50-75 years old with prostate-specific antigen (PSA) between 2.5-10 ng/ml and a prior negative biopsy in the placebo arm of the Reduction by Dutasteride of PCa Events (REDUCE) trial, who were diagnosed with PCa in a prostate biopsy and underwent RP during the study interval. All biopsy slides were read central and systematically graded for PA was defined as absent or present. PCa grade was defined as low-grade (Gleason 2-6) or high-grade (Gleason 7-10). The association of baseline PA with PCa grade in the surgical specimen was evaluated with logistic regression in uni- and multivariable analysis, controlling for baseline patient characteristics.

Results

Among 137 men diagnosed with PC who underwent an RP in REDUCE, 64 (46.7%) had PA in the baseline prostate biopsy. The presence of PA was not associated with baseline patient characteristics (age, body-mass index, PSA levels, prostate volume, race, family history of PCa or digital rectal exam, all P>0.05, Table). The presence of baseline PA was associated with lower risk of high-grade PCa (OR=0.40, 95%CI=0.20-0.80, P=0.010) in the surgical specimen. Results were unchanged in multivariable analysis (OR=0.46, 95%CI=0.22-0.96, P=0.039).

Conclusions

In a cohort of men with negative baseline biopsy who were eventually found to have PCa in a repeat prostate biopsy and underwent RP, the presence of baseline PA was independently associated with lower risk of high-grade PCa in the surgical specimen. PA seems to be associated with lower PCa risk and aggressiveness.

Funding

None