Multiple negative surveillance prostate biopsies for men on active surveillance indicate low volume prostate cancer and are correlated with favorable clinical outcomes (J Urol. 2021;205[1]:109-114. doi:10.1097/JU.0000000000001339).
Men with low-risk prostate cancer suitable for active surveillance undergo multiple biopsies over time. Multiple negative biopsies are associated with reduced risk of disease progression, but it is unknown whether they can predict better long-term outcomes.
“In this study we aim to examine the clinical significance of consecutively negative surveillance biopsies for men initially diagnosed with low-risk prostate cancer on active surveillance,” wrote the study authors. “We further hypothesize that consecutively negative biopsies can anticipate better long-term treatment-free survival and undergo less intensive surveillance regimens,” they continued.
Researchers performed a single center study of men prospectively enrolled on active surveillance with at least 4 biopsies. Inclusion criteria were 0, 1, or 2 consecutively negative biopsies after diagnosis. Outcome variables were the detection of any cancer at the fourth biopsy and active treatment.
Authors studied a total of 514 men; of those, 22% had 1 negative biopsy, and 15% had 2 consecutively negative biopsies. For men with negative biopsies, median prostate-specific antigen density was lower, the likelihood of detecting cancer at the outcome biopsy was lower, and 10-year treatment-free survival was higher.
“Consecutively negative surveillance biopsies are correlated with favorable clinical risk factors and independently associated with subsequent negative biopsy and lower risk of active treatment,” concluded the study authors.—Lisa Kuhns
