HealthDay News — Initial diagnostic characteristics may be able to identify men initiating active surveillance who could avoid confirmatory biopsy, according to a study published in the January issue of The Journal of Urology.

Prassannah Satasivam, MD, from the Memorial Sloan Kettering Cancer Center in New York City, and colleagues assessed whether initial diagnostic parameters (prostate-specific antigen density, magnetic resonance imaging result, percent positive cores, percent cancer in positive cores, and total tumor length) could predict the confirmatory biopsy result in 392 men (with Gleason 6 prostate cancer on initial biopsy) undergoing confirmatory biopsy.

The researchers found that 11% of men had high-grade cancer on confirmatory biopsy. In univariate analysis, all predictors were significantly associated with high-grade cancer at confirmatory biopsy. However, only prostate-specific antigen density and total tumor length were significantly associated in the multivariable model (area under the curve, 0.85).

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“Using this model to select patients for confirmatory biopsy would generally provide a higher net benefit than performing confirmatory biopsy in all patients, across a wide range of threshold probabilities,” the authors write.

Several authors disclosed financial ties to the diagnostics and pharmaceutical company Opko.


  1. Satasivam P, Poon BY, Behfar E, et al. Can confirmatory biopsy be omitted in patients with prostate cancer favorable diagnostic features on active surveillance? J Urology. 2016;195(1)74-79. doi: 10.1016/j.juro.2015.07.078
  2. Bruinsma SM, Bokhorst LP, Roobol MJ, Bangma CH. How often is biopsy necessary in patients with prostate cancer on active surveillance? J Urology. 2016;195(1):11-12. doi: 10.1016/j.juro.2015.10.061