Anterior-Dominant Prostate Cancer Harder to Detect Than Other Locations

By Reuters Staff

January 22, 2020

NEW YORK (Reuters Health) - Anterior-dominant prostate cancer is harder to detect and presents with higher prostate-specific antigen (PSA) levels than prostate cancer in other locations, according to a database study.

About 10%-25% of prostate cancers show anterior predominance. Cancers in this location tend to be underdiagnosed at biopsy and undergraded when detected.

Dr. Cristina Magi-Galluzzi of the University of Alabama at Birmingham and colleagues contrast the pathological features and clinical outcomes of 132 men with anterior-predominant prostate cancer (APCA) and 353 matched men with posterior-predominant prostate cancer (PPCA), all of whom had been treated with radical prostatectomy for localized prostate cancer.

PSA at diagnosis was slightly higher among men with APCA (6.4 ng/mL) than among men with PPCA (5.6 ng/mL), and significantly more men with APCA (19.7%) than with PPCA (13.0%) presented with a PSA greater than 10 ng/mL.

Significantly fewer men with APCA (10.1%) than with PPCA (23.2%) had abnormal digital rectal examination at diagnosis, and surgical upgrading was more common in men with APCA than in those with PPCA 55.3% vs. 42.0%, P=0.015), the researchers report in Prostate Cancer and Prostatic Diseases.

Despite these differences, "freedom from biochemical failure" at three and five years did not differ significantly between men with APCA (90.1% and 85.1%, respectively) and men with PPCA (91.9% and 82.9%).

"These results suggest that there are no significant differences in clinical outcomes in APCA compared to PPCA following prostatectomy, despite the diagnostic challenges of detecting these tumors with conventional prostate biopsy templates," the authors conclude.

Dr. Magi-Galluzzi could not be reached for comment.

SOURCE: Prostate Cancer and Prostatic Diseases, online January 3, 2020.