PD48-07 CLINICAL USE OF PROSTATE HEALTH INDEX (PHI) FOR DETECTION OF PROSTATE CANCER IN 3,318 PATIENTS

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening V (PD48)1 Apr 2020PD48-07 CLINICAL USE OF PROSTATE HEALTH INDEX (PHI) FOR DETECTION OF PROSTATE CANCER IN 3,318 PATIENTS John Richgels*, Joel Wackerbarth, Brian Helfand, and Alexander Glaser John Richgels*John Richgels* More articles by this author , Joel WackerbarthJoel Wackerbarth More articles by this author , Brian HelfandBrian Helfand More articles by this author , and Alexander GlaserAlexander Glaser More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000942.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate health index (PHI) has consistently outperformed prostate-specific antigen (PSA) in detection of prostate cancer (PCa) and clinically-significant prostate cancer (csPCa) in the literature. We present the routine clinical use of PHI by multiple physicians in over 3,000 patients at a single tertiary care center. METHODS: Patients with a PHI result from 2017-2019 were identified using the Enterprise Data Warehouse. Clinical variables, PSA values, PHI scores, and prostate needle biopsy (PNB) results including Gleason Grade Group (GG) were extracted in accordance with an IRB-approved study. PHI scores were categorized into four risk categories (low PHI=0-26.9, average PHI=27-35.9, high 36-54.9, and very high PHI>55). The percentage of patients who underwent biopsy and subsequent prostate cancer GGs were compared with chi-square analysis and plotted with GraphPad Prism v8. ROC analysis was performed with R v3.5.1. RESULTS: Of the 3,318 unique patients who underwent PHI testing, 879 had a prior PNB and 2,440 were biopsy-naïve. Of the 879 patients with a prior PNB, 535 had a prior negative PNB, and 294 had a prior PNB with GG1 PCa. Increasing PHI values were associated with PNB and the likelihood of being diagnosed with PCa and csPCa in the total cohort and the subset of biopsy-naïve patients (p<0.0001, Figure 1A-B). Of 294 patients with a prior diagnosis of GG1 PCa who underwent repeat PNB after PHI testing, only 4% of patients with low-risk PHI were found to have csPCa, and the detection of GG1 PCa was expectedly similar across groups (p=0.11, Figure 1C). In 535 patients with a prior negative PNB, detection of csPCa was exclusively limited to patients with a high or very high PHI score (PHI>36; p<0.0001 Figure 1D). The area under the curve (AUC) to detect any PCa was 0.59 for PSA and 0.65 for PHI (p=0.02). The AUC to detect csPCa was 0.62 for PSA and 0.72 for PHI (p<0.001, Figure 2). CONCLUSIONS: We report the largest series to date of the use of PHI in routine clinical practice. PHI outperforms PSA in detection of PCa and csPCa. Men with a prior negative biopsy and PHI <36 may be at very low risk of csPCa. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e996-e997 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information John Richgels* More articles by this author Joel Wackerbarth More articles by this author Brian Helfand More articles by this author Alexander Glaser More articles by this author Expand All Advertisement PDF downloadLoading ...