MP38-04 BASELINE PROSTATE HEALTH INDEX RISK CATEGORY AND RISK CATEGORY CHANGES DURING ACTIVE SURVEILLANCE PREDICT GRADE RECLASSIFICATION

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP38-04 BASELINE PROSTATE HEALTH INDEX RISK CATEGORY AND RISK CATEGORY CHANGES DURING ACTIVE SURVEILLANCE PREDICT GRADE RECLASSIFICATION Claire De La Calle, Yuezhou Jing, Mufaddal Mamawala, Patricia Landis, Katarzyna Macura, Bruce Trock, Jonathan Epstein, Lori Sokoll, and Christian Pavlovich Claire De La CalleClaire De La Calle More articles by this author , Yuezhou JingYuezhou Jing More articles by this author , Mufaddal MamawalaMufaddal Mamawala More articles by this author , Patricia LandisPatricia Landis More articles by this author , Katarzyna MacuraKatarzyna Macura More articles by this author , Bruce TrockBruce Trock More articles by this author , Jonathan EpsteinJonathan Epstein More articles by this author , Lori SokollLori Sokoll More articles by this author , and Christian PavlovichChristian Pavlovich More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003276.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We sought to determine if repeated prostate health index (PHI) tests during active surveillance (AS) are of clinical value in a contemporary AS cohort followed with multiparametric magnetic resonance imaging (mpMRI) and biopsies of the prostate. METHODS: We identified 382 patients in our AS program with at least one mpMRI and one PHI test, of which 241 had at least two PHI tests. All men had ≥Grade group 1 (GG1) prostate cancer on diagnostic and confirmatory biopsy. Grade reclassification (GR) was defined as ≥GG2 identified on surveillance biopsy. PHI risk categories 1-4 were as defined by the manufacturer. A multivariable Cox proportional hazard regression model was performed to evaluate the association between baseline PHI risk category and GR, and change in PHI risk categories over time and GR, respectively. RESULTS: Men with baseline PHI scores in the highest risk categories had lower rates of GR-free survival (log-rank p<0.001; Figure). On multivariable Cox regression baseline PHI risk category was a predictor of GR (model C-index 0.769; Table A). Men with an increase in PHI risk category or consistently high PHI (risk category 3-4) (compared to baseline PHI) experienced more upgrading (36/112=32.1% vs 27/129=20.9%, p=0.048). On multivariable Cox proportional hazards model with PHI risk category as a time-dependent variable, increasing PHI risk category demonstrated increasing association with GR (model C-index 0.762, Table B). CONCLUSIONS: Both baseline PHI risk category and PHI risk category over time were predictors of GR after confirmatory biopsy. The model with PHI category changes over time did not perform better than the model with baseline PHI risk category. PHI is a non-invasive and easy to obtain test, so further evaluation of its clinical utility in reducing the frequency of mpMRI and/or surveillance biopsies and in improving risk stratification is warranted. Source of Funding: Ralph T. and Esther L. Warburton Foundation and Dr. Hugh Judge Jewett Fellowship in Urologic Oncology © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e524 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Claire De La Calle More articles by this author Yuezhou Jing More articles by this author Mufaddal Mamawala More articles by this author Patricia Landis More articles by this author Katarzyna Macura More articles by this author Bruce Trock More articles by this author Jonathan Epstein More articles by this author Lori Sokoll More articles by this author Christian Pavlovich More articles by this author Expand All Advertisement PDF downloadLoading ...