You have accessJournal of UrologyCME1 May 2022MP53-13 TRANSITION OF PROSTATE CANCER PRIMARY DIAGNOSTICS: TAKEOVER OF MRI-GUIDED TARGETED- VERSUS SYSTEMATIC BIOPSY Mykyta Kachanov, Sami-Ramzi Leyh-Bannurah, Christoph Würnschimmel, Dirk Beyersdorff, Fabian Falkenbach, Tobias Maurer, Hendrik Isbarn, Thomas Steuber, Markus Graefen, and Lars Budäus Mykyta KachanovMykyta Kachanov More articles by this author , Sami-Ramzi Leyh-BannurahSami-Ramzi Leyh-Bannurah More articles by this author , Christoph WürnschimmelChristoph Würnschimmel More articles by this author , Dirk BeyersdorffDirk Beyersdorff More articles by this author , Fabian FalkenbachFabian Falkenbach More articles by this author , Tobias MaurerTobias Maurer More articles by this author , Hendrik IsbarnHendrik Isbarn More articles by this author , Thomas SteuberThomas Steuber More articles by this author , Markus GraefenMarkus Graefen More articles by this author , and Lars BudäusLars Budäus More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002628.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To explore stage migration patterns of primary diagnostic tools of prostate cancer, namely systematic biopsy (SBx) and the dawn of MRI-targeted biopsy (TBx) combined with SBx. METHODS: Within our institutional database, we identified 7,470 SBx and 1,717 TBx+SBx patients, who received respective primary diagnostics between 2005-2020 and 2016-2020. The estimated annual percentage changes (EAPC) for Gleason Grade Groups (GGG) and for proportion strata of PCa yield, within overall biopsy tissue was calculated by a log linear regression methodology. For TBx+SBx, adjustment according to PIRADS strata 3,4 and 5 was performed. RESULTS: At SBx, the incidence of GGG 1 (EAPC -3.45) and GGG 3 (EAPC -3.51) significantly decreased, accompanied by an increase of GGG 5 (EAPC +10; p=0.003). Similarly, proportion of biopsy tissue PCa yield >20% also significantly increased (EAPC: +3.71; p=0.002). After TBx+SBx was introduced at our institution 2016, the percentage of TBx+SBx for purpose of primary PCa diagnostics (as opposed to repeat Bx) increased from 12% to 52% until 2020. There were no significant EAPCs of TBx+SBx GGGs within this period. During the period 2016-2020, clinically significant GGG ≥2 was detected at a significantly higher rate of 58% at TBx+SBx compared to 46% at SBx, respectively. CONCLUSIONS: Increased high-risk GGG 5 proportions at SBx strongly suggest that previously observed inverse stage migration pattern of unfavorable PCa characteristics at first diagnosis are still present in contemporary PCa patients. However, the greater comparable yield of clinically significant PCa at TBx+SBX also indicates that the inverse stage migration of SBx might systematically underestimate truly aggressive PCa burden due to poorer diagnostic performance. This must be taken into account when considering a primary biopsy examination, supporting the existing recommendations regarding primary MRI and TBx based diagnostics. Source of Funding: none © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e900 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mykyta Kachanov More articles by this author Sami-Ramzi Leyh-Bannurah More articles by this author Christoph Würnschimmel More articles by this author Dirk Beyersdorff More articles by this author Fabian Falkenbach More articles by this author Tobias Maurer More articles by this author Hendrik Isbarn More articles by this author Thomas Steuber More articles by this author Markus Graefen More articles by this author Lars Budäus More articles by this author Expand All Advertisement PDF DownloadLoading ...