MP60-11 PERFORMANCE OF PROSTATIC SPECIFIC ANTIGEN DENSITY (PSAD) PREDICTING CLINICALLY SIGNIFICANT PROSTATE CANCER (csPCa) IN BIOPSY NAIVE MEN, WITH A PRIOR NEGATIVE TRUS BIOPSY, OR LOW-GRADE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Markers (MP60)1 Sep 2021MP60-11 PERFORMANCE OF PROSTATIC SPECIFIC ANTIGEN DENSITY (PSAD) PREDICTING CLINICALLY SIGNIFICANT PROSTATE CANCER (csPCa) IN BIOPSY NAIVE MEN, WITH A PRIOR NEGATIVE TRUS BIOPSY, OR LOW-GRADE CANCER Vassilios Skouteris, Nelson Stone, Paul Arangua, Priya Werahera, Paul Maroni, Francisco G. La Rosa, M. Scott Lucia, and E. David Crawford Vassilios SkouterisVassilios Skouteris More articles by this author , Nelson StoneNelson Stone More articles by this author , Paul AranguaPaul Arangua More articles by this author , Priya WeraheraPriya Werahera More articles by this author , Paul MaroniPaul Maroni More articles by this author , Francisco G. La RosaFrancisco G. La Rosa More articles by this author , M. Scott LuciaM. Scott Lucia More articles by this author , and E. David CrawfordE. David Crawford More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002095.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A PSAD ≤0.15 mg/mL2 may reduce the need to perform a prostate biopsy because csPCa is not often encountered. However, the PSAD level with the highest area under the curve (AUC) may differ for men who are biopsy naïve (BN), had a prior negative TRUS biopsy (NTB), or with a diagnosis of Gleason grade group 1 (GG1). We investigated the performance characteristics of PSAD in these groups of men who subsequently underwent transperineal mapping biopsy (TPMB). METHODS: 371 men who were BN (n=141), had NTB (n=87) or GG1 (n=143) and a PSA < 10 ng/ml had template guided TPMB. PSAD levels of 0.1, 0.125, 0.15, 0.175 and 0.20 mg/mL2 were compared to the histopathology findings of TPMB. Area under the curves (AUC) were determined from the receiver operating characteristics. Men with Gleason grade group 2-5 (csPCa) were compared to the others (no cancer and GG1) for the 3 biopsy groups. Associations of TPMB results to PSAD levels were compared by ANOVA (with Bonferroni correction), chi-square (Pearson) and logistic regression (LR). RESULTS: The mean+SD age, PSA, prostate gland volume, PSAD, number of TPMB cores, and number of TPMB positive cores were 64.7+8.3 years, 5.2+2.3 ng/mL, 44.3+18.6 ml, 0.13+0.08 mg/mL2 , 57.4+22.2, and 6.2+5.5. TPMB was positive in 67.7% with 134 GG1 and 117 GG2-5. The AUCs for the different PSAD levels for BN, NTB and GG1 are shown in the table. For BN PSAD <0.125 had the greatest AUC (0.685, p<0.001), for TNB PSAD <0.15 (0.701, 0.575-0.827, p=0.003) and GG1 PSAD <0.10 (0.659, p=0.002). CsPCa was present in 71.7 vs. 17.3% for BN with a PSAD > 0.125 (OR 4.8, 95%CI 2.2-10.8, p<0.001), 61.5 vs. 17.2% for NTB with a PSDA > 0.15 (OR 5.9, 95%CI 2.2-16.1, p<0.001) and 77.3% vs. 15.6% for GG1 with a PSAD >0.1 (OR 4.1, 95%CI 1.8-9.2, p<0.001). Age (p=0.004) and PSAD 0.1 (p=0.023) were significant on LR. There was no difference in the number of specimens with csPCa in the 3 biopsy groups. CONCLUSIONS: Based on the results of a TPMB, the PSAD level that decreases the need to perform a biopsy should be adjusted according to the biopsy status of the patients. Men who are biopsy naïve with a PSAD < 0.125, those who had a prior negative TRUS biopsy with a PSAD ≤ 0.15 or men with GG1 and a PSAD ≤ 0.10 who forgo biopsy have a 17% chance of harboring csPCa by mapping biopsy. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1045-e1046 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Vassilios Skouteris More articles by this author Nelson Stone More articles by this author Paul Arangua More articles by this author Priya Werahera More articles by this author Paul Maroni More articles by this author Francisco G. La Rosa More articles by this author M. Scott Lucia More articles by this author E. David Crawford More articles by this author Expand All Advertisement Loading ...