MP64-10 MRI-GUIDED BIOPSY TO EVALUATE PROSTATE CANCER SEVERITY IN AFRICAN-AMERICAN MEN

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History II (MP64)1 Apr 2020MP64-10 MRI-GUIDED BIOPSY TO EVALUATE PROSTATE CANCER SEVERITY IN AFRICAN-AMERICAN MEN Jorge Ballon, Ryan Chuang*, Adam Kinnaird, Rajiv Jayadevan, Steve Zhou, Danielle Barsa, Lorna Kwan, and Leonard Marks Jorge BallonJorge Ballon More articles by this author , Ryan Chuang*Ryan Chuang* More articles by this author , Adam KinnairdAdam Kinnaird More articles by this author , Rajiv JayadevanRajiv Jayadevan More articles by this author , Steve ZhouSteve Zhou More articles by this author , Danielle BarsaDanielle Barsa More articles by this author , Lorna KwanLorna Kwan More articles by this author , and Leonard MarksLeonard Marks More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000939.010AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The mortality rate of prostate cancer has long been considered higher among African-American (AA) men. Most diagnostic information has been obtained by ultrasound-guided prostate biopsy. To study the possibility that MRI-guided biopsy might provide histologic clarification of the apparent disparity, we studied use of the new modality in AA and other men at three time points in prostate cancer care: 1) at diagnosis, 2) during active surveillance, and 3) at final pathology after radical prostatectomy. METHODS: Subjects were 1002 consecutive men who underwent MRI-guided biopsy combining both systematic and lesion-targeted sampling between 2009-2018. Pathologic upgrading was defined as an increase in Gleason Grade group (GG) at structured follow-up biopsy during active surveillance (AS) or at whole-mount sectioning (prostatectomy). Statistical significance (p<0.05) was assessed using the Mann-Whitney-U test for continuous data, the Chi-square test (or Fisher's exact if necessary) for categorical data, and the Kaplan-Meier estimator to calculate progression-free survival probabilities. RESULTS: AA men (N=57) had higher rates of prostate cancer at diagnostic biopsy than other men (N=945) (79% AA vs 66% others; p=0.05). GG was similar in both groups: AA vs Other: GG <2, 25% vs 20%; GG3, 12% vs 10%; GG >4, 9% vs 9% (p=0.76). Upgrading at prostatectomy was found in 3/29 (10%) AA men and 32/262 (12%) other men (p=0.45). Among low-risk men in AS, Gleason upgrading during a median follow up of 4 years was found in 5/16 (31%) AA men and 93/274 (34%) other men (p=0.80). CONCLUSIONS: In our cohort studied with contemporary MRI-guided biopsy, aggressiveness of prostate cancer (judged histologically) was the same for both groups at initial biopsy, at prostatectomy, and during AS. Unlike similar investigations that used only ultrasound-guided biopsy, a method little changed from the 1980s, we found with the improved technology, no significant histologic differences between AA and other men at three important points in prostate cancer care. This suggests that differences previously observe were not based on physiology alone. Furthermore, these data indicate that after MRI-guided biopsy, entry into AS programs for AA men with prostate cancer is appropriate when low-risk pathology is determined using MRI-guided biopsy. Source of Funding: R01CA218547, R01CA195505 © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e966-e967 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jorge Ballon More articles by this author Ryan Chuang* More articles by this author Adam Kinnaird More articles by this author Rajiv Jayadevan More articles by this author Steve Zhou More articles by this author Danielle Barsa More articles by this author Lorna Kwan More articles by this author Leonard Marks More articles by this author Expand All Advertisement PDF downloadLoading ...