PD17-10 THE SIGNIFICANCE OF MULTIPLE NEGATIVE BIOPSIES IN PATIENTS ON ACTIVE SURVEILLANCE

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance I (PD17)1 Sep 2021PD17-10 THE SIGNIFICANCE OF MULTIPLE NEGATIVE BIOPSIES IN PATIENTS ON ACTIVE SURVEILLANCE Nabila Khondakar, Jillian Egan, Luke O'Connor, Michael Ahdoot, Cheyenne Williams, Michael Daneshvar, Nitin Yerram, Jeunice Owens-Walton, Patrick Gomella, Sandeep Gurram, Peter Choyke, Maria Merino, Bradford Wood, Baris Turkbey, and Peter Pinto Nabila KhondakarNabila Khondakar More articles by this author , Jillian EganJillian Egan More articles by this author , Luke O'ConnorLuke O'Connor More articles by this author , Michael AhdootMichael Ahdoot More articles by this author , Cheyenne WilliamsCheyenne Williams More articles by this author , Michael DaneshvarMichael Daneshvar More articles by this author , Nitin YerramNitin Yerram More articles by this author , Jeunice Owens-WaltonJeunice Owens-Walton More articles by this author , Patrick GomellaPatrick Gomella More articles by this author , Sandeep GurramSandeep Gurram More articles by this author , Peter ChoykePeter Choyke More articles by this author , Maria MerinoMaria Merino More articles by this author , Bradford WoodBradford Wood More articles by this author , Baris TurkbeyBaris Turkbey More articles by this author , and Peter PintoPeter Pinto More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001999.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Low-risk prostate cancer patients receive multiple biopsies over the course of active surveillance (AS). MRI enables earlier detection of disease and may help to risk-stratify patients. We aimed to assess the significance of multiple negative biopsies in AS patients who received MRI per our AS protocol. We also compared disease progression in patients who had multiple combined MRI-targeted and 12-core systematic biopsies (combined biopsy), versus multiple systematic biopsies alone. METHODS: We queried our database of patients referred for possible AS between 2007 and 2020, and who had confirmatory biopsy. Patients with at least three total biopsies (diagnostic, confirmatory, and follow-up) and Gleason Grade ≤2 on confirmatory biopsy were included. Negative biopsy was defined as no cancer on any biopsy cores. Kaplan-Meier survival analysis was used to assess time to progression. Analyses were repeated in subgroups who received combined vs. systematic biopsy. RESULTS: A total of 219 patients met inclusion criteria. Median age at confirmatory biopsy was 62 years. Distribution of biopsy results was as follows: 107 patients (48.9%) had zero negative biopsies, 49 (22.3%) had consecutive negative biopsies, 51 (23.3%) had only one negative biopsy, and 11 (5.0%) had non-consecutive negative biopsies. Having multiple negative biopsies was associated with longer progression free survival (PFS) (log-rank p<0.0001). When stratified by biopsy type, multiple negative combined biopsies were associated with longer PFS (p<0.0001) whereas multiple negative systematic biopsies were not (p=0.34). Median time to progression was 3.1 years with zero negative biopsies, 6.5 years with one negative biopsy, 7.7 years with consecutive negative biopsies, and 8.3 years with non-consecutive negative biopsies. CONCLUSIONS: In an AS cohort of patients with GG ≤2 at time of confirmatory biopsy, having at least one negative biopsy was associated with PFS time more than double that of patients with no negative biopsies. Our findings suggest that patients with multiple negative prostate biopsies do not require frequent surveillance biopsies that traditionally have been offered to AS patients. Source of Funding: NIH Intramural Funding, NIH Medical Research Scholars Program, Foundation for the NIH © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e288-e288 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nabila Khondakar More articles by this author Jillian Egan More articles by this author Luke O'Connor More articles by this author Michael Ahdoot More articles by this author Cheyenne Williams More articles by this author Michael Daneshvar More articles by this author Nitin Yerram More articles by this author Jeunice Owens-Walton More articles by this author Patrick Gomella More articles by this author Sandeep Gurram More articles by this author Peter Choyke More articles by this author Maria Merino More articles by this author Bradford Wood More articles by this author Baris Turkbey More articles by this author Peter Pinto More articles by this author Expand All Advertisement Loading ...