PD17-07 IS CONFIRMATORY BIOPSY STILL NECESSARY IN MEN WITH GRADE GROUP 1 PROSTATE CANCER IN THE MULTIPARAMETRIC MRI ERA?

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance I (PD17)1 Sep 2021PD17-07 IS CONFIRMATORY BIOPSY STILL NECESSARY IN MEN WITH GRADE GROUP 1 PROSTATE CANCER IN THE MULTIPARAMETRIC MRI ERA? Yasin Bhanji, Mufaddal Mamawala, Sean Fletcher, Patricia Landis, Katarzyna Macura, and Christian Pavlovich Yasin BhanjiYasin Bhanji More articles by this author , Mufaddal MamawalaMufaddal Mamawala More articles by this author , Sean FletcherSean Fletcher More articles by this author , Patricia LandisPatricia Landis More articles by this author , Katarzyna MacuraKatarzyna Macura More articles by this author , and Christian PavlovichChristian Pavlovich More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001999.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Men with low-risk prostate cancer (PCa) considering active surveillance (AS) undergo a confirmatory biopsy (CB) within 6-12 months of diagnostic biopsy (DB) to guide decision-making for inclusion in AS protocols. Other clinical variables, such as PSA and multiparametric prostate MRI (mpMRI), are also used to determine AS eligibility. We sought to compare rates of upgrading on CB between men who received a pre-DB MRI and those who did not. We hypothesized that the upgrading rate would be comparatively lower in men with a pre-DB mpMRI. METHODS: We studied a cohort of men diagnosed with GG1 PCa on DB who underwent CB in 2019-2020. Patients were stratified into two groups (Figure). The first group underwent mpMRI prior to DB; if a PIRADS≥3 lesion was present, the patient received systematic biopsy (SB) + targeted biopsy (TB). If no lesion was present, then only SB was performed. The second group underwent DB without mpMRI, then had mpMRI prior to CB which followed the aforementioned biopsy protocol. Primary outcome was detection on CB of Gleason ≥3+4 (Grade Group [GG]≥2) PCa. RESULTS: 247 men had a DB demonstrating only GG1 PCa. 111 of these (44%) underwent pre-biopsy mpMRI and thus MRI-informed DB (Group 1), of whom 28 (25%) upgraded to GG>1 at CB. 136 men (55%) underwent DB followed by mpMRI-informed CB (Group 2), of whom 30 (22%) upgraded to GG>1 at CB. 41 (37%) men in Group 1 had a negative mpMRI (PI-RADS≤2) and of these, 7 (17%) were diagnosed with GG>1 PCa at CB (NPV of mpMRI for GG>1= 83%). 62 (45%) men in group 2 had a negative mpMRI, 7 (11.2%) of whom were diagnosed with GG>1 prostate cancer at CB (NPV 89%; p=0.6 compared to group 1). Time interval between DB and CB was not associated with upgrading overall or in either group. CONCLUSIONS: Rates of upgrading to GG>1 on CB were similar in men who had an mpMRI-informed DB (25%) and in those who did not have a pre-DB mpMRI (22%). This suggests that men considering AS benefit from a CB (SB+TB as needed) regardless of the presence of pre-DB mpMRI or of mpMRI findings. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e287-e287 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yasin Bhanji More articles by this author Mufaddal Mamawala More articles by this author Sean Fletcher More articles by this author Patricia Landis More articles by this author Katarzyna Macura More articles by this author Christian Pavlovich More articles by this author Expand All Advertisement Loading ...