MP38-08 IS A CONFIRMATORY PROSTATE BIOPSY BEFORE ENTRY INTO AN ACTIVE SURVEILLANCE PROTOCOL STILL NECESSARY IN THE ERA OF PROSTATE CANCER DIAGNOSIS WITH MRI-GUIDED BIOPSY?

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP38-08 IS A CONFIRMATORY PROSTATE BIOPSY BEFORE ENTRY INTO AN ACTIVE SURVEILLANCE PROTOCOL STILL NECESSARY IN THE ERA OF PROSTATE CANCER DIAGNOSIS WITH MRI-GUIDED BIOPSY? Omri Schwarztuch Gildor, Anna Itshak, Yarden Fleischer, Ilan Leibovitch, Itay Sagy, and Itay Sternberg Omri Schwarztuch GildorOmri Schwarztuch Gildor More articles by this author , Anna ItshakAnna Itshak More articles by this author , Yarden FleischerYarden Fleischer More articles by this author , Ilan LeibovitchIlan Leibovitch More articles by this author , Itay SagyItay Sagy More articles by this author , and Itay SternbergItay Sternberg More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003276.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In patients with low-risk prostate cancer who are considering active surveillance (AS), it is common to repeat a biopsy within a year of diagnosis, as a confirmatory biopsy. The necessity of this biopsy was tested in the era before diagnosis based on MRI and showed a risk of 25-35% for reclassification in the confirmatory biopsy. Currently, most biopsies and new diagnoses of patients with a tumor suitable for AS are performed under the guidance of MRI. Our goal is to check the chance of reclassification when the diagnosis was made with an MRI-guided biopsy. METHODS: A retrospective review of all confirmatory biopsies performed at our center between 2015-2021. Data were collected about the diagnostic biopsy and the confirming biopsy based on the medical sheet and the pathological report. RESULTS: Of the 114 patients who underwent a confirmatory biopsy during the study period, 75 (65.8%) were diagnosed with a TRUS biopsy (group 1) and 39 (34.2%) with an MRI-guided biopsy (group 2). Patient age, PSA level, prostate size, PSA-D, and MRI findings were similar between groups. All confirmatory biopsies were performed with MRI guidance and included also systematic sampling. Reclassification to grade group (GG) ≥ 2 in the confirming biopsy was found in 31/75 (41.3%) and 15/39 (38.5%) patients in groups 1 and 2, respectively. This difference is not statistically significant (p=0.77). Similar reclassification rate (3/8, 37.5%) occurred in a subgroup (of group 2) of patients with previous negative systematic biopsy. In 9/75 (12.0%) and 4/39 (10.3%) patients in groups 1 and 2, respectively, the MRI-guided samples were found without significant prostate cancer and reclassification was made only because of the systematic samples. CONCLUSIONS: The risk of reclassification in a confirmatory biopsy continues to be significant even in the era of MRI-guided diagnosis of prostate cancer. We emphasize the importance of continuing to perform confirmatory biopsies and ensuring systematic sampling alongside sampling the region of interest. Source of Funding: Self funding © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e526 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Omri Schwarztuch Gildor More articles by this author Anna Itshak More articles by this author Yarden Fleischer More articles by this author Ilan Leibovitch More articles by this author Itay Sagy More articles by this author Itay Sternberg More articles by this author Expand All Advertisement PDF downloadLoading ...