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Prostate Cancer: Staging (MP11): Moderated Poster 11: Friday, September 10, 2021

MP11-07 CLINICAL BENEFIT OF A HIGH CONCORDANCE BETWEEN TRANSPERINEAL TARGETED PLUS SYSTEMATIC MAPPING BIOPSIES AND RADICAL PROSTATECTOMY

Wettstein, Marian S.; Grogg, Josias B.; Affentranger, Andres; Cruz, Camille; Grossmann, Nico C.; Hermanns, Thomas; Poyet, Cédric; Fankhauser, Christian D.

doi: 10.1097/JU.0000000000001984.07
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INTRODUCTION AND OBJECTIVE:

Accurate diagnosis in men with suspected prostate cancer (PC) is essential when several alternative treatment options to radical prostatectomy (RP) such as active surveillance, brachytherapy, radiotherapy, and focal treatment are available. The selection of treatment options heavily depends on the accuracy of tissue sampling during prostate biopsy. However, the concordance of ultrasound guided systematic transrectal prostate biopsy (SB) and RP specimens is limited. To improve the diagnostic accuracy of biopsy results, multiparametric MRI (mpMRI) of the prostate followed by transperineal targeted biopsies (TB) using MRI ultrasound scanning fusion with additional systematic mapping biopsies (SMB) is increasingly used to obtain tissue from men with suspected prostate cancer. The aim of our study was to quantify the concordance between mpMRI-TB-SMB and RP in patients undergoing RP for PC.

METHODS:

Patients undergoing RP for ISUP 2-5 PC in a tertiary referral center were included in this retrospective analysis. Whereas SB included systemic biopsies of 12 predefined regions in the prostate, mpMRI-TB-SMB was performed by taking biopsy cores from 20 predefined regions of the prostate and from MRI-suspicious lesions after fusion. Concordance was descriptively assessed by confusion matrices.

RESULTS:

We identified a cohort of 873 patients of which 530 (60.7%) underwent SB while 343 (39.3%) received mpMRI-TB-SMB. In men with biopsy proven ISUP 2 PC, upgrade to ISUP 3-5 using mpMRI-TB-SMB compared to SB decreased from 35.2% to 28.2% and downgrade to ISUP 1 decreased from 3.5% to 0%. In men with ISUP 2-3 PC, upgrade to ISUP 4-5 decreased from 14.4% to 5.4% and downgrade to ISUP 1 decreased from 2.7% to 0%.

CONCLUSIONS:

The improved concordance between mpMRI-TB-SMB and RP compared to SB and RP offers patients more accurate treatment allocation and may improve outcomes.

Source of Funding:

None

© 2021 by American Urological Association Education and Research, Inc.