MP46-19 MULTI-INSTITUTIONAL COMPARISON AND EXPERIENCE OF UPGRADING RATES OF STANDARD VS. TARGETED PROSTATE BIOPSIES

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening IV1 Apr 2018MP46-19 MULTI-INSTITUTIONAL COMPARISON AND EXPERIENCE OF UPGRADING RATES OF STANDARD VS. TARGETED PROSTATE BIOPSIES Jonathan B. Bloom, Nabeel Shakir, Niccolo Passoni, Sam Gold, Daniel Wong, Graham Hale, Kareem Rayn, Joseph Baiocco, Sherif Mehralivand, Vladimir Valera, Maria Merino, Bradford J. Wood, Peter L. Choyke, Baris Turkbey, Claus Roehrborn, and Peter A. Pinto Jonathan B. BloomJonathan B. Bloom More articles by this author , Nabeel ShakirNabeel Shakir More articles by this author , Niccolo PassoniNiccolo Passoni More articles by this author , Sam GoldSam Gold More articles by this author , Daniel WongDaniel Wong More articles by this author , Graham HaleGraham Hale More articles by this author , Kareem RaynKareem Rayn More articles by this author , Joseph BaioccoJoseph Baiocco More articles by this author , Sherif MehralivandSherif Mehralivand More articles by this author , Vladimir ValeraVladimir Valera More articles by this author , Maria MerinoMaria Merino More articles by this author , Bradford J. WoodBradford J. Wood More articles by this author , Peter L. ChoykePeter L. Choyke More articles by this author , Baris TurkbeyBaris Turkbey More articles by this author , Claus RoehrbornClaus Roehrborn More articles by this author , and Peter A. PintoPeter A. Pinto More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1478AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES With the advent of multi-parametric Magnetic Resonance Imaging (mpMRI), lesions within the prostate can be targeted with fusion biopsy platforms. This has improved the detection of clinically significant (CS) prostate cancer while decreasing the detection of indolent disease. We sought to compare the upgrading rates in two distinct populations of patients. METHODS A review of prospectively maintained databases of patients who underwent mpMRI then both targeted (TB) and standard template biopsy (SB) was conducted from two high volume institutions. Baseline demographics were obtained as well as pathological results of both biopsies. RESULTS 1913 patients were included with 1673 from the NCI and 240 from UTSW. The main difference in these populations consisted of number of prior biopsies, 1388/1673 (82.96%) NCI vs 106/240 (44.17%) UTSW, p<0.0001, prior negative biopsies 630/1673 (37.66%) NCI vs 54/240 (22.5%) UTSW, p<0.0001 and proportion of African-Americans, 255/1673 (15.24%) NCI vs 26/240 (6.67%) UTSW, p=0.0002. The overall upgrading rate of any Gleason group (GG) via targeted biopsy was 423/1910 (22.11‰) with 344/1913 (20.56%) NCI and 79/240 (32.92%) UTSW, p<0.001. Upgrading from clinically insignificant to CS (GG ≥ 2) disease occurred in 332/1308 (25.38%) with 266/1202 (22.13%) from NCI and 66/106 (62.26%) from UTSW, p<0.001. The upgrading rate to any higher GG via SB occurred in 696/1913 (36.38%) with 628/1673 (37.53%) NCI and 68/240 (28.33%) UTSW. Table 1 demonstrates the biopsy results of the cohort with CS missed disease denoted in red. CS disease was detected by both SB and TB in 194/408 (46.55%) patients. SB undergraded 151/408 (37.01%) while TB undergraded 63/408 (15.44%), p<0.001. Multivariate regression showed race and institution were not associated with TB upgrading while age (OR 1.05; 1.4-1.07), PSA (OR 1.07; 1.05-1.08), MRI volume (OR 0.97; 0.97-0.98), and prior biopsy, (OR 0.59; 0.44-0.79) were associated. CONCLUSIONS In a population who has been biopsed often, the upgrading rate of targeted biopsies is lessened, but remains advantageous. In populations with more biopsy-naive patients and likely higher cancer prevalence, we see upgrading by both TB and SB. Both populations benefitted from the combination of TB and SB, which may be considered as standard of care. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e614 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Jonathan B. Bloom More articles by this author Nabeel Shakir More articles by this author Niccolo Passoni More articles by this author Sam Gold More articles by this author Daniel Wong More articles by this author Graham Hale More articles by this author Kareem Rayn More articles by this author Joseph Baiocco More articles by this author Sherif Mehralivand More articles by this author Vladimir Valera More articles by this author Maria Merino More articles by this author Bradford J. Wood More articles by this author Peter L. Choyke More articles by this author Baris Turkbey More articles by this author Claus Roehrborn More articles by this author Peter A. Pinto More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...