There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.
Abstract
We have previously reported (1987) that a positive biopsy from a clinically normal
prostate eighteen months or more after interstitial Iodine 125 or external beam irradiation
predicted disease progression. In the present study, all biopsies were reexamined
by the same pathologist (LEL) and correlated with long-term patient status. Of twenty-six
positive biopsy specimens, twenty-two were reconfirmed as positive and four were reassigned
to a negative diagnosis (false positive = 15%). Seventy-two of seventy-seven negative
specimens were available for reexamination and seventy were reconfirmed as negative
while two were reassigned to a positive diagnosis (false negative = 2%). A statistically
higher incidence of local and/or distant failure for patients with positive biopsy
specimens compared with patients with negative biopsy specimens was again confirmed
(p = < 0.001). However, there is a group of patients with a positive biopsy (17%)
who remain clinically free of disease at greater than ten years of follow-up. Therefore,
a positive biopsy is not an absolute indication of imminent failure. Our results demonstrate
the technical difficulty and potential error in interpreting prostate biopsies after
radiation therapy. Therapeutic decisions should be based not only on biopsy histology
but must also weigh the patient's initial tumor stage and grade, current clinical
examination, PSA level, age, and health.