MP30-14 5-ARI USAGE ASSOCIATED WITH MORE ADVANCED PROSTATE CANCER AT DIAGNOSIS

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening III (MP30)1 Sep 2021MP30-14 5-ARI USAGE ASSOCIATED WITH MORE ADVANCED PROSTATE CANCER AT DIAGNOSIS Emily Roebuck, Wei Sha, Caroline Lu, Caroline Miller, Earle F Burgess, Claud M Grigg, Jason Zhu, Kris E Gaston, Stephen B Riggs, Justin T Matulay, Peter E Clark, and James T Kearns Emily RoebuckEmily Roebuck More articles by this author , Wei ShaWei Sha More articles by this author , Caroline LuCaroline Lu More articles by this author , Caroline MillerCaroline Miller More articles by this author , Earle F BurgessEarle F Burgess More articles by this author , Claud M GriggClaud M Grigg More articles by this author , Jason ZhuJason Zhu More articles by this author , Kris E GastonKris E Gaston More articles by this author , Stephen B RiggsStephen B Riggs More articles by this author , Justin T MatulayJustin T Matulay More articles by this author , Peter E ClarkPeter E Clark More articles by this author , and James T KearnsJames T Kearns More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002027.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate cancer (PCa) risk is often modeled at referral based on Prostate Cancer Prevention Trial (PCPT) and Prostate Biopsy Collaborative Group (PBCG) risk calculators, which account for factors such as PSA, DRE, age, race, family history, and prior biopsy history. Prospective PCa chemoprevention trials noted an increased risk of high-grade prostate cancer among men using 5-ARIs, and subsequent retrospective data associates 5-ARI use with delayed diagnoses and worse cancer outcomes than non-users. The objective of this study was to assess clinical characteristics and treatment types between 5-ARI users versus non-users at prostate biopsy and PCa diagnosis. METHODS: Men undergoing prostate biopsy at our institution between January 2018–December 2021 were retrospectively reviewed for clinical and demographic data. Patients with previously diagnosed PCa were excluded. For categorical demographic or biopsy variables, Chi-square test was used to determine if there is a significant association between these variables and 5-ARI usage. For continuous demographic variables, quantile regression was used to compare the medians between 5-ARI users and non-users. False discovery rate (FDR) adjusted P value was used for multiple tests. RESULTS: Among 842 patients, 83 men were using 5-ARIs at time of biopsy (Table 1). Demographic characteristics including age, race, marital status, BMI, or family history were similar across the two cohorts. PSA was greater among 5-ARI users (p=.054). At PCa diagnosis, 5-ARI users tended to have higher clinical T stage (p<0.0001) and NCCN risk group stratification (p=.0119). Gleason Grade Group (p=0.372), prostate volume (p=.1838), DRE (p=.5849), and treatment type (p>.05 for all) were not statistically different between users and non-users. CONCLUSIONS: While not emphasized in common risk calculators, pre-diagnostic use of 5-ARI should be considered when deciding to biopsy. Our findings demonstrate 5-ARI usage associated with more advanced clinical T stage and higher NCCN risk though not Gleason Grade, suggesting that 5-ARI is a risk factor to consider at referral and highlighting the need to optimize diagnostic care for 5-ARI users. Source of Funding: No source of funding © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e505-e505 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Emily Roebuck More articles by this author Wei Sha More articles by this author Caroline Lu More articles by this author Caroline Miller More articles by this author Earle F Burgess More articles by this author Claud M Grigg More articles by this author Jason Zhu More articles by this author Kris E Gaston More articles by this author Stephen B Riggs More articles by this author Justin T Matulay More articles by this author Peter E Clark More articles by this author James T Kearns More articles by this author Expand All Advertisement Loading ...