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

Prostate Cancer Detection in Men with an Initial Diagnosis of Atypical small Acinar Proliferations. Dr Charles Chabert The Wollongong Hospital. Definition. ASAP denotes the presence of suspicious glands with insufficient cytological or architectural atypia for a definitive cancer diagnosis.

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

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  1. Prostate Cancer Detection in Men with an Initial Diagnosis of Atypical small Acinar Proliferations Dr Charles Chabert The Wollongong Hospital

  2. 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; 24:819

  3. Objective Determine the clinical significance of ASAP in prostate biopsies

  4. Methods Illawarra prostate pathology data base reviewed Jan 1994- Jan 2004 ASAP Pathology reviewed Clinical records obtained

  5. Method Study cohort 31 Median age: 65 years (53-78 years) Median PSA: 7.6ng/ml (0.3-36ng/ml)

  6. Results ASAP 31 22 Second Biopsy 9 No further Biopsy

  7. Results of No Repeat Biopsy 9 No repeat biopsy Median F/U: 8 78 months 1 CAP TURP: 1 Benign

  8. Results ASAP 31 9 No further Biopsy 22 Second Biopsy

  9. Results of 2nd Biopsy ASAP 22/31 Benign 4 Prostate cancer 13 ASAP 5 Median interval between 1st & 2nd biopsy 8 Months

  10. Prostate Ca in 2nd Biopsy 3+4=7 (5) 4+4=8 (3) 13/22 Prostate Cancer 4+5=9 (1) 3+3=6 (2) 4+3=7 (2)

  11. Results of 2nd Biopsy ASAP 22/31 Prostate cancer 13 Benign 4 ASAP 5

  12. Results of 3rd Biopsy ASAP 5 All Biopsied Prostate Ca 2 Benign 2 ASAP 1 Median interval between 2nd & 3rd 14 months

  13. Results of 2nd Biopsy ASAP 22/31 Benign 4 Prostate cancer 13 ASAP 5

  14. Results of 3rd Biopsy Benign: 4 CAP 4+3=7 Benign 2 ASAP 1

  15. Summary Subsequent CAP detection 17/31 54.8 % ASAP diagnosis mandates rebiopsy

  16. Acknowledgement Dr Sabar Napaki, Southern Pathology, Wollongong

  17. High Grade PIN ASAP

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