PD28-09 DOES MRI-FUSION PROSTATE BIOPSY IMPROVE RISK RECLASSIFICATION FOR PATIENTS WITH PROSTATE CANCER ON ACTIVE SURVEILLANCE COMPARED TO TRANSRECTAL ULTRASOUND-GUIDED SATURATION BIOPSY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance I1 Apr 2017PD28-09 DOES MRI-FUSION PROSTATE BIOPSY IMPROVE RISK RECLASSIFICATION FOR PATIENTS WITH PROSTATE CANCER ON ACTIVE SURVEILLANCE COMPARED TO TRANSRECTAL ULTRASOUND-GUIDED SATURATION BIOPSY Ahmed El Shafei, Yaw Nyame, Hans Arora, Mohamed Eltemamy, Onder Kara, Ercan Malkoc, Khaled Fareed, and J Stephen Jones Ahmed El ShafeiAhmed El Shafei More articles by this author , Yaw NyameYaw Nyame More articles by this author , Hans AroraHans Arora More articles by this author , Mohamed EltemamyMohamed Eltemamy More articles by this author , Onder KaraOnder Kara More articles by this author , Ercan MalkocErcan Malkoc More articles by this author , Khaled FareedKhaled Fareed More articles by this author , and J Stephen JonesJ Stephen Jones More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1243AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES It has been shown that transrectal ultrasound (TRUS)-guided saturation prostate biopsy (SB) improves detection of prostate cancer (PCa) progression or risk reclassification compared to extended prostate biopsy (EB) in patients who elect for active surveillance (AS). This study aims to compare the accuracy of MRI-fusion biopsy to SB in detecting PCa reclassification in patients on AS. METHODS We reviewed 228 prostate biopsies from 177 patients diagnosed with PCa who elected AS. Only patients who fit the low risk NCCN criteria were included: Gleason score (GS) ≤ 6, PSA ≤ 10 ng/ml, clinical stage T1 or T2a, and percentage of positive cores ≤ 33% of total cores sampled at the time of diagnostic biopsy. Pathological progression or reclassification on surveillance biopsies was defined as no longer meeting the standard definition of low risk by Gleason score and/or disease volume. RESULTS The mean age of men at diagnosis was 66.7 (SD ±8.3) years. Among 228 prostate biopsies, 53 were MRI fusion biopsies and 175 were SB (≥ 20 cores). Disease reclassification was seen in 77/175 (44%) of SB and 19/53 (36%) in MRI fusion biopsies. 13 of 19 patients underwent disease reclassification detected by a combination protocol of both MRI targeted and standard biopsy, while 6/19 were reclassified by MRI targeted biopsy alone. A greater degree of disease re-classification was seen with the SB technique as compared to both targeted-only MRI-fusion targeted biopsy (44% vs. 11.3%, P<0.0001) and combined systematic and targeted MRI fusion biopsy (44% vs. 24.5%, P=0.01). We further compared the rate of cancer progression (reclassification) at the time of each subsequent surveillance biopsy (Table 1, 2). CONCLUSIONS In patients with low risk PCa who elect for AS, we demonstrated that SB might confer a better rate of detection for reclassification than protocols involving MRI fusion techniques for confirmatory or surveillance biopsies at our institution. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e521 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Ahmed El Shafei More articles by this author Yaw Nyame More articles by this author Hans Arora More articles by this author Mohamed Eltemamy More articles by this author Onder Kara More articles by this author Ercan Malkoc More articles by this author Khaled Fareed More articles by this author J Stephen Jones More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...