MP44-14 PREBIOPSY MRI APPROACH FOR PROSTATE CANCER DIAGNOSIS IS ASSOCIATED WITH LOWER RISK OF BIOCHEMICAL RECURRENCE AFTER TREATMENT

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP44-14 PREBIOPSY MRI APPROACH FOR PROSTATE CANCER DIAGNOSIS IS ASSOCIATED WITH LOWER RISK OF BIOCHEMICAL RECURRENCE AFTER TREATMENT Fernando Blank, Neha Debnath, Shima Tayebi, Amy Cherry, Juliana Tobler, Sadhna Verma, and Abhinav Sidana Fernando BlankFernando Blank More articles by this author , Neha DebnathNeha Debnath More articles by this author , Shima TayebiShima Tayebi More articles by this author , Amy CherryAmy Cherry More articles by this author , Juliana ToblerJuliana Tobler More articles by this author , Sadhna VermaSadhna Verma More articles by this author , and Abhinav SidanaAbhinav Sidana More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003290.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To determine the impact of prebiopsy prostate magnetic resonance imaging (MRI) followed by a targeted biopsy (TBx) approach for initial diagnosis on oncological outcomes after prostate cancer (PCa) treatment. METHODS: We performed a retrospective review of all patients who underwent prostate biopsy followed by radiation therapy (RT) or radical prostatectomy (RP) as their first treatment at our center from 2014-2020. Patients were separated into two cohorts based on the diagnostic approach: prebiopsy prostate MRI during initial evaluation and those who did not receive MRI. Patients with positive MRI findings underwent a combination of TBx and systematic biopsy (SBx) to confirm diagnosis while those without MRI underwent SBx only. Patients with prostate specific antigen (PSA) >20 were excluded. Kaplan-Meier curve analysis was used to compare biochemical recurrence (BCR, defined as PSA>0.2ng/ml after RP or a rise of 2ng/ml after RT) between cohorts. Cox proportional hazard analysis was done to determine the predictors of the BCR. RESULTS: 366 patients (174 diagnosed by SBx only, and 192 diagnosed by prebiopsy MRI and TBx) with a median follow-up of 40 months were included in the study. 245 men (67%) had RP as their first treatment. Median age and PSA were 64.7 and 7.9 respectively in the SBx cohort and 65.0 and 8.3 respectively in TBx cohort. There was a significant difference in BCR rate between the TBx (7.98%) versus SBx (19.28%, p<0.05 by log rank). After adjusting for age, race, PSA, biopsy path, DRE, and family history, prebiopy MRI and TBx approach for diagnosis was found to be an independent negative predictor (p=0.001); with patients diagnosed with the above approach 71% less likely to have BCR during the study period. CONCLUSIONS: Our study shows that patients undergoing prebiopsy MRI followed by TBx have lower rates of BCR compared to men diagnosed without prebiopsy MRI. To our knowledge, this study is the first to show the positive impact of prebiopsy MRI on oncological outcomes, likely due to its role in risk stratification, treatment selection and surgical staging and planning. Further longitudinal studies are needed to discern the true long-term benefits of prebiopsy MRI on oncological outcomes. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e617 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Fernando Blank More articles by this author Neha Debnath More articles by this author Shima Tayebi More articles by this author Amy Cherry More articles by this author Juliana Tobler More articles by this author Sadhna Verma More articles by this author Abhinav Sidana More articles by this author Expand All Advertisement PDF downloadLoading ...