Racial variation in prostate needle biopsy templates directed anterior to the peripheral zone

• Published in: Urologic oncology 2016-08, Vol.34 (8), p.336.e1-336.e6
• Main Authors: Feibus, Allison H., M.S, Levy, Justin, McCaslin, Ian R., M.D, Doucet, Meggie E., M.D, Sholl, Andrew B., M.D, Moparty, Krishnarao, M.D, Thomas, Raju, M.D., M.H.A., F.A.C.S, Sartor, Oliver, M.D, Silberstein, Jonathan L., MD
• Format: Article
• Language: English
• Subjects: African American; African Americans; Anterior to peripheral zone; Biopsy, Needle; Humans; Male; Prostate biopsy; Prostate cancer; Prostate-Specific Antigen - blood; Prostatectomy; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - ethnology; Racial variation; Reproducibility of Results; Urology
• ISSN: 1078-1439; 1873-2496
• DOI: 10.1016/j.urolonc.2016.03.017

Abstract Objectives African Americans (AA) have been reported to have both increased incidence and increased aggressiveness of prostate cancer (PCa) located anterior to the peripheral zone (APZ). We sought to evaluate the utility of prostate biopsies directed toward the APZ in a predominantly AA cohort. Methods and materials We reviewed all patients with PCa found on biopsy schema that included needle biopsies directed at both the peripheral zone (PZ) and APZ from 2010 to 2014. Self-identified race was recorded for all patients. To evaluate the reliability of APZ-directed prostate biopsies, we performed pathologic secondary review of 25 radical prostatectomy specimens. A series of the Mann-Whitney U and Chi-square tests were used to compare variables. Results We identified 398 men, of which 277 (70%) were AA. Compared with non-AA, AA had more National Comprehensive Cancer Network-defined intermediate or high-risk (50% vs. 39%, P = 0.25) PCa. Most patients had PCa limited to the PZ only ( n = 190) or in both the PZ and APZ ( n = 191). For 17 patients (4%), PCa was limited only to the APZ core(s), 14 (5%) AA vs. 3 (2%) non-AA ( P = 0.24). Most of these 17 patients ( n = 14, 82%) had Gleason 6 disease. Patients with PCa in both the PZ and APZ had higher serum prostate-specific antigen, prostate-specific antigen density, volume of disease, and increased grade and National Comprehensive Cancer Network category (all P