MP38-10 MULTI-INSTITUTIONAL VALIDATION OF THE PRECISE CRITERIA ON PROSTATE MRI DURING ACTIVE SURVEILLANCE

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP38-10 MULTI-INSTITUTIONAL VALIDATION OF THE PRECISE CRITERIA ON PROSTATE MRI DURING ACTIVE SURVEILLANCE Francesco Giganti, Armando Stabile, Riccardo Leni, Mark Emberton, Caroline M. Moore, Massimo Valerio, Veeru Kasivisvanathan, and Precise Study Group Francesco GigantiFrancesco Giganti More articles by this author , Armando StabileArmando Stabile More articles by this author , Riccardo LeniRiccardo Leni More articles by this author , Mark EmbertonMark Emberton More articles by this author , Caroline M. MooreCaroline M. Moore More articles by this author , Massimo ValerioMassimo Valerio More articles by this author , Veeru KasivisvanathanVeeru Kasivisvanathan More articles by this author , and Precise Study GroupPrecise Study Group More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003276.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Currently, AS programmes vary across the world, with different timings in terms of follow-up on MRI and biopsy. The PRECISE criteria provide a dedicated 1-to-5 scale to evaluate the radiological change on serial MRI: a PRECISE score of 1 or 2 denotes radiological regression, PRECISE 3 indicates stability and PRECISE 4 or 5 implies progression. We report the first validation of the PRECISE score in a multicentre international setting. METHODS: We collected data from 22 centres across the world and applied two entry criteria: i) at least 2 MR scans (baseline and follow-up); ii) at least 2 biopsies (baseline and follow-up, the latter after the second MR). Local radiologists reported the scans using PRECISE. Histological progression was defined as any increase in Gleason Score from baseline biopsy. Progression-free survival (PFS) was estimated using Kaplan-Meier curves with landmark time starting from date of first follow-up MRI (i.e., second MR), and multivariable Cox proportional hazards model tested the predictive role of PRECISE. RESULTS: A total of 1,556 patients were included, 1389 (89%) of which had Gleason 3+3 and 167 (11%) had Gleason ≥ 3+4 at baseline. Median follow-up was 48 months, and 513 (33%) patients experienced histological progression. The overall 5- and 10-year progression-free survival (PFS) were 66% and 41%, with time starting at diagnosis. For PRECISE 1-2 (n=158), PFS was 88% at 2 years from first follow-up MRI and 77% at 5 years, while for PRECISE 4-5 (n=413), PFS was 52% and 35%. In those with PRECISE 3 [stability] and visible lesions (n=597), 2- and 5-year PFS was 76% and 50%, while for PRECISE 3 [stability] and non-visible lesions (n=388), PFS was similar to PRECISE 1-2 (2- and 5-year PFS: 91% and 80%) (Log Rank p<0.001). At multivariable analysis, PRECISE 4-5 remained an independent predictor of histological progression (HR: 2.63; p<0.0001). CONCLUSIONS: Our work has validated the PRECISE score in a multicentre setting and has the potential to be included in future risk models that incorporate both clinical and radiological data to fully benefit from prostate MRI and targeted biopsies. Source of Funding: Prostate Cancer Foundation / CRIS Cancer Foundation (Francesco Giganti is a recipient of the 2020 Young Investigator Award). © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e527 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Francesco Giganti More articles by this author Armando Stabile More articles by this author Riccardo Leni More articles by this author Mark Emberton More articles by this author Caroline M. Moore More articles by this author Massimo Valerio More articles by this author Veeru Kasivisvanathan More articles by this author Precise Study Group More articles by this author Expand All Advertisement PDF downloadLoading ...