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Active surveillance: does serial prostate biopsy increase histological inflammation?

A S Glass¹, S P Porten, M Bonham

¹Department of Urology, University of California, San Francisco, CA 94143-1695, USA. GlassA@urology.ucsf.edu

Prostate Cancer and Prostatic Diseases

|January 16, 2013

Summary

Histological inflammation in men on active surveillance (AS) for prostate cancer increased slightly with more biopsies but did not predict disease progression. This finding is crucial for monitoring low-risk prostate cancer patients.

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Area of Science:

Urology
Pathology
Oncology

Background:

Active surveillance (AS) is a key strategy for managing low-risk prostate cancer.
Standard AS protocols involve repeat prostate biopsies every 12-24 months for disease monitoring.

Purpose of the Study:

To investigate histological inflammation patterns in men undergoing serial prostate biopsies for active surveillance of prostate cancer.
To determine if inflammation severity correlates with the number of biopsies or disease progression.

Main Methods:

Retrospective review of 56 men on AS with diagnostic and repeat transrectal ultrasound-guided biopsies.
Pathological assessment of inflammatory infiltrate type and degree.
Statistical analysis using repeated measures mixed models and t-tests/chi-square analysis.

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Main Results:

A small, significant increase in maximum chronic inflammation (CI) scores was observed with a higher number of repeat biopsies.
CI scores were not associated with prostate cancer grade progression (Gleason sum increase).
Study limitations include small sample size and potential unmeasured confounders.

Conclusions:

Chronic histological inflammation increases with the number of prostate biopsies in men on AS.
Increased inflammation in this pilot study did not correlate with an increased risk of subsequent grade progression.
Further research with larger cohorts is needed to confirm these findings.