Negative biopsies in patients with early-stage prostate cancer who have chosen active surveillance are associated with a low risk of disease progression, but they are not a sign that their cancer is completely gone, says a new study.
Active surveillance refers to watching closely for signs of cancer progression – often referred to as “watchful waiting”. Patients sometimes undergo prostate-specific antigen testing (PSA), prostate exams, imaging, and repeat biopsies.
The goal of active surveillance is to avoid or delay treatment and its side effects without putting patients at risk of cancer progression and death.
Sometimes patients under active surveillance have negative biopsies that show no signs of prostate cancer. While some of these patients may believe their cancer is “gone,” they most likely have small or small hidden areas of prostate cancer that were not detected in the biopsy sample, the authors say. of the study recently published in The urology journal.
“While a negative biopsy is good news, the long-term implications associated with such ‘hidden’ cancers are unclear,” said study author Dr Carissa Chu of the University. from California to San Francisco.
For the study, Chu and colleagues analyzed data from 514 men who were actively watched for early-stage prostate cancer between 2000 and 2019. All had at least three surveillance biopsies after their initial cancer diagnosis. prostate. The median duration of follow-up was almost 10 years.
Of those patients, 37% had at least one negative biopsy, including 15% with consecutive negative biopsies, according to the report.
Men with negative biopsies had more favorable disease characteristics, including low PSA density and fewer samples with cancer during the initial prostate biopsy. Negative biopsies were also associated with good long-term results, the researchers said.
After 10 years, the survival rates without treatment for prostate cancer (such as surgery or radiation therapy) were 84% for men with consecutive negative biopsies, 74% for those with negative biopsy, and 66% for those without negative biopsies.
After adjusting for other factors, the researchers concluded that men with one or more negative biopsies were much less likely to have cancer detected on a subsequent biopsy.
“For men under active surveillance, negative biopsies indicate low volume disease and lower rates of disease progression,” Chu said in a press release. “These ‘hidden’ cancers have excellent long-term results and remain ideal for ongoing active surveillance.”
There is more on prostate cancer at the US National Cancer Institute.
SOURCE: The urology journal, press release, November 17, 2020, By Robert Preidt, HealthDay reporter