RISK OF CONCURRENT PROSTATE-CANCER IN CYSTOPROSTATECTOMY SPECIMEN IS RELATED TO VOLUME OF HIGH-GRADE PROSTATIC INTRAEPITHELIAL NEOPLASIA

Objectives. To assess the relationship of prostatic intraepithelial ne oplasia (PIN) with both incidental and clinical carcinoma of the prost ate. Methods. We retrospectively reviewed prostate histology in 48 men (group 1) who underwent surgical removal of the prostate for diagnose s other than prostate cancer, as well as in 64 men (group 2) who under went radical prostatectomies. Both groups were assessed for the presen ce and extent of high-grade [HG-) PIN and compared with respect to pat ient age, Gleason score, and volume of prostate cancer. Results. HG-PI N was present in 40 of 48 (83%) group I cases. Forty-six percent of th ese cases (22 of 48) had incidental prostate cancer. Twenty-nine of 48 (60%) group I patients with HG-PIN had multifocal or extensive diseas e. Twenty of 22 (91%) incidental prostate cancers were present in 29 p rostates with multifocal or extensive HG-PIN. In contrast, only 2 of 1 9 (11%) cases with absent to focal HC-PIN had prostate cancer. The ass ociation of multifocal or extensive HG-PIN with incidental prostate ca ncer was significant (P = 0.001); the relationships of extent of HG-PI N and cancer volume (P = 0.06) or high Gleason score (P = 0.017) were not significant. HG-PIN was present in 61 of 64 (95%) group 2 cases, T he associations of extent of HG-PIN and cancer volume (P = 0.169) or h igh Gleason score (P = 0.156) were not significant. Conclusions. Both the low rate of incidental prostate cancer in specimens with absent to focal HG-PIN and the high rate of cancer in specimens with multifocal or extensive HG-PIN suggest that HG-PIN is a marker for concurrent pr ostate cancer and that the risk of concurrent prostate cancer is relat ed to the volume of HG-PIN in the prostate gland. (C) 1997, Elsevier S cience Inc.