MP16-17 TEN YEAR UPGRADING RATE AFTER PROSTATECTOMY IN THE MRI AND FUSION BIOPSY ERA

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy III1 Apr 2018MP16-17 TEN YEAR UPGRADING RATE AFTER PROSTATECTOMY IN THE MRI AND FUSION BIOPSY ERA Samuel Gold, Graham Hale, Jonathan Bloom, Kareem Rayn, Joseph Baiocco, Sherif Mehralivand, Vladimir Valera Romero, Clayton Smith, Marcin Czarniecki, Maria Merino, Brad Wood, Peter Choyke, Baris Turkbey, and Peter Pinto Samuel GoldSamuel Gold More articles by this author , Graham HaleGraham Hale More articles by this author , Jonathan BloomJonathan Bloom More articles by this author , Kareem RaynKareem Rayn More articles by this author , Joseph BaioccoJoseph Baiocco More articles by this author , Sherif MehralivandSherif Mehralivand More articles by this author , Vladimir Valera RomeroVladimir Valera Romero More articles by this author , Clayton SmithClayton Smith More articles by this author , Marcin CzarnieckiMarcin Czarniecki More articles by this author , Maria MerinoMaria Merino More articles by this author , Brad WoodBrad Wood More articles by this author , Peter ChoykePeter Choyke More articles by this author , Baris TurkbeyBaris Turkbey More articles by this author , and Peter PintoPeter Pinto More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.551AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Multiparametric magnetic resonance imaging (mpMRI) has vastly improved visualization of prostate cancer (PCa) and provided image guidance for fusion biopsy of suspicious lesions. This has led to better detection of clinically significant PCa as compared to traditional ultrasound-guided systematic biopsy (Sbx). In this study, we report on 10 years of fusion biopsy results in patients who went on to undergo robotic-assisted radical prostatectomy (RARP). METHODS A prospectively maintained database from 2007-2017 was used to identify all patients who had mpMRI and fusion biopsy--consisting of both mpMRI-guided targeted biopsy (Tbx) and 12-core Sbx--prior to RARP at a single institution. Gleason score detected on fusion biopsy was then compared to pathologic grading after RARP. Baseline demographics, mpMRI features, and histologic grading from biopsies was collected for each patient. Chi square tests determined significance in differences between biopsy results. RESULTS A total of 580 patients were identified who had a RARP after mpMRI. Of those, 383 patients had both mpMRI and fusion biopsy performed at our institution. 77/383 (20.1%) of the fusion biopsy cases were upgraded after RARP. This rate is improved over upgrading rates of Sbx 158/383 (41.3%), p<0.001, and Tbx 126/383 (32.9%) alone, p<0.001. On multivariate logistic regression, prostate-specific antigen, age, race, number of MRI lesions, size of lesion on MRI, and prostate volume were not significant associated risk factors for upgrade for fusion biopsies, SBx, or Tbx. CONCLUSIONS Fusion biopsy (consisting of Tbx and Sbx) demonstrated a significantly lower rate of upgrading on final pathology versus Tbx or Sbx alone. Thus, it may not yet be time to skip Sbx in favor of Tbx alone. Furthermore, as previously reported by our institution, the upgrading rate has decreased over the last 10 years as fusion biopsy technical proficiency has increased. As mpMRI and fusion biopsy platforms continue to progress, fusion biopsy remains the most accurate modality for prostate lesion sampling. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e203 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Samuel Gold More articles by this author Graham Hale More articles by this author Jonathan Bloom More articles by this author Kareem Rayn More articles by this author Joseph Baiocco More articles by this author Sherif Mehralivand More articles by this author Vladimir Valera Romero More articles by this author Clayton Smith More articles by this author Marcin Czarniecki More articles by this author Maria Merino More articles by this author Brad Wood More articles by this author Peter Choyke More articles by this author Baris Turkbey More articles by this author Peter Pinto More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...