PD57-07 FACTORS PREDICTING CLINICALLY SIGNIFICANT PROSTATE CANCER IN PIRADS 4 LESIONS

Abstract

You have accessJournal of UrologyCME1 May 2022PD57-07 FACTORS PREDICTING CLINICALLY SIGNIFICANT PROSTATE CANCER IN PIRADS 4 LESIONS Mohammad Siddiqui, Jasmine Lin, Jonathan Aguiar, Brandon Ansbro, Moataz Soliman, Jordan Rich, Johan Alfaro, Mary-Kate Keeter, Quan Mai, Edward Schaeffer, and Ashley Ross Mohammad SiddiquiMohammad Siddiqui More articles by this author , Jasmine LinJasmine Lin More articles by this author , Jonathan AguiarJonathan Aguiar More articles by this author , Brandon AnsbroBrandon Ansbro More articles by this author , Moataz SolimanMoataz Soliman More articles by this author , Jordan RichJordan Rich More articles by this author , Johan AlfaroJohan Alfaro More articles by this author , Mary-Kate KeeterMary-Kate Keeter More articles by this author , Quan MaiQuan Mai More articles by this author , Edward SchaefferEdward Schaeffer More articles by this author , and Ashley RossAshley Ross More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002637.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The PIRADS 4 lesions are commonly biopsied, however many are benign. Here, we sought to investigate factors that may help better risk stratify the PIRADS-4 lesions and predict the presence of clinically significant cancer (defined as Gleason Grade Group (GG) ≥ 2). METHODS: We queried the electronic medical record for patients diagnosed with PIRADS 4 lesions beginning in March 2018 with the focus on patients with total PSA 2-20ng/mL. We compared the clinical characteristics such as Age, African American race, PSA, prostate health index (PHI), and PSA Density (PSAD) of patients with and without clinically significant prostate cancer on biopsy. Statistics were performed using t-test, chi-squared analysis, and logistical regressions with significance defined as p<0.05. RESULTS: From March 2018 to present, 3553 men presented to urology with suspicion of prostate cancer and 1640 (46%) underwent prostate MRI. 571 (35%) of men were identified to have the PIRADS 4 lesion as their highest PIRADS lesion (Table 1). 556 (97%) men with PIRADS 4 lesions underwent prostate needle biopsy. Clinically significant cancer was detected in 288 (52%) of this population (206 (37%) men had negative biopsies, while GG1 was found in 61 (11%)). Predictors of identifying clinically significant prostate cancer on biopsy on multivariable analysis included African American race (OR 3.76, 95% CI 1.86-7.59), PSAD >0.15 (OR 3.01, 95% CI 1.5-5.74) and higher PHI (PHI>36 (OR 3.42, CI 1.58-7.4), PHI≥ 55(OR 10.5, 95% CI 4.07-25.1)). CONCLUSIONS: Consistent with literature, 37% of PIRADS 4 lesions are benign in our series. Our results suggest that men of AA race, or those with PSAD> 0.15, or PHI >36 and PIRADS 4 lesions should undergo prostate biopsy. Men with PSAD < 0.1 and PHI scores in the lowest quartile were least likely to have clinically significant prostate cancer on biopsy of PIRADS 4 lesions. Source of Funding: UROLOGY CARE FOUNDATION RESIDENCY RESEARCH AWARD © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e962 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohammad Siddiqui More articles by this author Jasmine Lin More articles by this author Jonathan Aguiar More articles by this author Brandon Ansbro More articles by this author Moataz Soliman More articles by this author Jordan Rich More articles by this author Johan Alfaro More articles by this author Mary-Kate Keeter More articles by this author Quan Mai More articles by this author Edward Schaeffer More articles by this author Ashley Ross More articles by this author Expand All Advertisement PDF DownloadLoading ...