Prognostic Significance of High-Grade Prostatic Intraepithelial Neoplasia (HGPIN): Risk of Prostatic Cancer on Repeat Biopsies

Gallo, Fabrizio; Chiono, Luciano; Gastaldi, Emilio; Venturino, Ezio; Giberti, Claudio

doi:10.1016/j.urology.2007.11.115

Cited by 32 publications

(25 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[6][7][8][9] However, some clinical studies showed that patients with HGPIN have a low risk of further cancer diagnosis but not higher than that observed in cases with a benign diagnosis. [10][11][12][13][14] In any case, after the introduction of extended bioptic schemes with 10/12 samples, the rate of cancer diagnosis after HGPIN decreased from the values up to 80% of the sextant biopsy era to the current 20-30%; probably, owing to a wider sampling, the diagnoses at rebiopsy that were previously not detected at the initial biopsy were avoided. 15 Therefore, it is still debated whether it is really necessary to repeat a biopsy for all the patients with HGPIN and EAU guidelines, 16 generically suggest an early rebiopsy only for multifocal HGPIN.…”

Section: Resultsmentioning

confidence: 99%

Predicting prostate cancer at rebiopsies in patients with high-grade prostatic intraepithelial neoplasia: a study on 546 patients

Antonelli

Tardanico

Giovanessi

et al. 2011

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

The aim of this study was to analyse the factors that predict the diagnosis of prostate cancer (PCa) after high-grade prostatic intraepithelial neoplasia (HGPIN). Data from 546 patients with HGPIN submitted up to a 6-month series of three rebiopsies, according to an institutional protocol, were reviewed. PCa has been found in 174 cases (31.8%), in 116 cases at the first and in 58 cases at a further rebiopsy. The risk of finding PCa at the first rebiopsy was correlated with the PSA value and with an anomalous digital rectal examination (DRE) at the time of the initial biopsy; the risk at a subsequent rebiopsy was correlated to the number of cores with HGPIN, with a cutoff of four, and to the ratio with the total number of cores ('PIN density'), with a cutoff of 50%, at the time of initial biopsy. A tailored protocol of controls can be suggested: (a) higher PSA value and/or anomalous DRE: early extended or saturation rebiopsy; (b) number of cores with HGPIN X4 and/or PIN density X50%: delayed rebiopsy; and (c) no risk factors: PSA and DRE controls.

show abstract

Section: Resultsmentioning

confidence: 99%

Predicting prostate cancer at rebiopsies in patients with high-grade prostatic intraepithelial neoplasia: a study on 546 patients

Antonelli

Tardanico

Giovanessi

et al. 2011

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

show abstract

“…It seems logical that malignant histological changes should be seen before such radical therapy is offered. It has been recently shown that PSA and HGPIN focality at biopsy do not enhance cancer predictivity, thus patients who underwent prostate biopsy with a HGPIN diagnosis do not seem to need any different follow-up rebiopsy strategy than patients with a diagnosis of BPH (Gallo et al, 2008).…”

Section: Radical Prostatectomy and Radiotherapymentioning

confidence: 99%

Prostate Cancer Precursor Diseases

Papatsoris¹,

Kostopoulos²,

Migdalis³

et al. 2012

Intraepithelial Neoplasia

View full text Add to dashboard Cite

“…41 More recent studies have since refuted this principle. 42,43 Prostate cancer prevention JL Silberstein and JK Parsons Five hundred and fourteen patients with biopsyproven HGPIN were randomized to 20, 40, or 60 mg toremifene, or placebo. Prostate biopsies were repeated at 6 months and 1 year.…”

Section: Primary Preventionmentioning

confidence: 99%

“…Still, given current clinical recommendations for HGPIN, toremifene should not be considered for prostate cancer prevention at this time. 42,44 Tertiary prevention…”

Section: Primary Preventionmentioning

confidence: 99%

Prostate cancer prevention: concepts and clinical recommendations

Silberstein

Parsons

2010

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

Prevention is an important strategy for limiting prostate cancer morbidity and mortality. Two major types of prevention are primary (reduction of incident cases) and tertiary (inhibition of disease progression and recurrence). Pharmacological and dietary interventions have potential functions in both the primary and tertiary prevention of prostate cancer. Five-a reductase inhibitors (5-ARIs) reduce the incidence of prostate cancer in both general and higher-risk populations and are currently under study for tertiary prevention in active surveillance and biochemical recurrence patients. Selenium, vitamin E, and vitamin C do not prevent incident prostate cancer in the general population; however, other promising diet-based interventions are currently under study for tertiary prevention. We recommend consideration of 5-ARIs for prostate cancer prevention in (1) asymptomatic men with a PSA p3.0 ng ml -1 who are undergoing or anticipate undergoing PSA screening for early detection of prostate cancer and (2) asymptomatic men with PSA X2.5 and p10 ng ml -1 and an earlier prostate biopsy negative for cancer. Men should be informed of the potential risks of 5-ARI therapy. Currently, there is neither clinical evidence to support the use of 5-ARIs for tertiary prevention in active surveillance or biochemical recurrence populations, nor micronutrients for prostate cancer prevention of any type.

show abstract

Prognostic Significance of High-Grade Prostatic Intraepithelial Neoplasia (HGPIN): Risk of Prostatic Cancer on Repeat Biopsies

Cited by 32 publications

References 22 publications

Predicting prostate cancer at rebiopsies in patients with high-grade prostatic intraepithelial neoplasia: a study on 546 patients

Predicting prostate cancer at rebiopsies in patients with high-grade prostatic intraepithelial neoplasia: a study on 546 patients

Prostate Cancer Precursor Diseases

Prostate cancer prevention: concepts and clinical recommendations

Contact Info

Product

Resources

About