Prostate Cancer Detection in Men with an Initial Diagnosis of Atypical small Acinar Proliferations

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Prostate Cancer Detection in Men with an Initial
Diagnosis of Atypical small Acinar Proliferations

• Dr Charles Chabert
• The Wollongong Hospital

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Definition

• ASAP denotes the presence of suspicious glands
  with insufficient cytological or architectural
  atypia for a definitive cancer diagnosis

Bostwick et al Hum Path.1993 24819
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(No Transcript)
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Objective

• Determine the clinical significance of ASAP in
  prostate biopsies

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Methods

• Illawarra prostate pathology data base reviewed
• Jan 1994- Jan 2004
• ASAP
• Pathology reviewed
• Clinical records obtained

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Method

• Study cohort 31
• Median age 65 years (53-78 years)
• Median PSA 7.6ng/ml (0.3-36ng/ml)

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Results
ASAP 31
9 No further Biopsy
22 Second Biopsy
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Results of No Repeat Biopsy
9 No repeat biopsy
Median F/U 8 78 months 1 CAP
TURP 1 Benign
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Results
ASAP 31
9 No further Biopsy
22 Second Biopsy
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Results of 2nd Biopsy

• ASAP
• 22/31

Benign 4
Prostate cancer 13
ASAP 5
Median interval between 1st 2nd biopsy 8
Months
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Prostate Ca in 2nd Biopsy
347 (5)
448 (3)

• 13/22
• Prostate Cancer

459 (1)
336 (2)
437 (2)
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Results of 2nd Biopsy

• ASAP
• 22/31

Prostate cancer 13
Benign 4
ASAP 5
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Results of 3rd Biopsy

• ASAP
• 5
• All Biopsied

Prostate Ca 2
Benign 2
ASAP 1
Median interval between 2nd 3rd 14 months
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Results of 2nd Biopsy

• ASAP
• 22/31

Benign 4
Prostate cancer 13
ASAP 5
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Results of 3rd Biopsy
Benign 4
CAP 437
Benign 2
ASAP 1
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Summary

• Subsequent CAP detection
• 17/31 54.8
• ASAP diagnosis mandates rebiopsy

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Acknowledgement

• Dr Sabar Napaki,
• Southern Pathology, Wollongong

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High Grade PIN
ASAP