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

MP11-10 RE-REFERRAL RATES IN THE MEDIUM TERM IN PATIENTS WITH A NON-SUSPICIOUS MPMRI WITHIN THE RAPID PATHWAY

Tanaka, Mariana Bertoncelli; Walter, Uma; Eldred-Evans, David; Bass, Edward J.; Connor, Martin J.; Sarkar, Pallab; Hoskings-Jervis, Feargus; Bhola-Stewart, Heather; Pegers, Elizabeth; Powell, Laura; Leelamany, Deepa; Wong, Kathie; Ahmad, Shahzad; Tam, Henry; Qazi, Hasan; Gordon, Stephen; Hrouda, David; McCracken, Stuart; Winkler, Mathias; Ahmed, Hashim U.

doi: 10.1097/JU.0000000000001984.10
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INTRODUCTION AND OBJECTIVE:

Our ‘one-stop’ Rapid Access Prostate Imaging and Diagnosis (RAPID) pathway across five hospitals in our region streamlined our one-stop mpMRI and if required, transperineal prostate biopsies. We report on the re-referral rates of men who had undergone previous investigation on the RAPID pathway.

METHODS:

Data from consecutive patients on the RAPID pathway (April/2017 to December/2020) was entered into the online RAPID registry. A transperineal targeted and systematic prostate biopsy (TP-Bx) was offered on the same day if the mpMRI score was 4 or 5. A score of 3 required a PSA density ≥ 0.12. The re-referral assessment was checked based on computer assistance.

RESULTS:

2869 patients with mean age 66 [IQR 59-72] and mean PSA 7.5 (5.8-11.3) were referred for prostate cancer investigation. In total, 49% [1406/2869] were discharged without a suspicion of cancer. 3% (37/1196) were rereferred by their GP due to ongoing concern for prostate cancer. Mean age was 67 (46-80) and mean PSA 9.5 (1.4-19.5). From those, 13 (35%) required biopsy in addition to MRI. Four (10%) had a histological diagnosis of prostate cancer of Gleason 3+4.

CONCLUSIONS:

RAPID is a safe pathway in the medium term when discharging men without biopsy following a non-suspicious mpMRI. After 3 years of follow-up, the mpMRI diagnostic pathway has a low re-referral rate and even on the rereferral group, 65% still did not meet criteria for a biopsy.

Source of Funding:

None

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