PD26-02 THE PROLONGED LOW RISK OF CLINICALLY SIGNIFICANT PROSTATE CANCER DIAGNOSIS IN MEN WITH AN ELEVATED PSA BUT LOW IsoPSA

You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance II (PD26)1 May 2024PD26-02 THE PROLONGED LOW RISK OF CLINICALLY SIGNIFICANT PROSTATE CANCER DIAGNOSIS IN MEN WITH AN ELEVATED PSA BUT LOW IsoPSA Nour Abdallah, Rebecca Campbell, Tarik Benidir, Andrew Wood, Zaeem Lone, Ao Zhang, Onuralp Ergun, Caleb Curry, Patrick Michael, Jay Chavali, Samuel Haywood, Zeyad Schwen, Ruben Olivares, Jihad Kaouk, Robert Abouassaly, Eric Klein, and Christopher Weight Nour AbdallahNour Abdallah , Rebecca CampbellRebecca Campbell , Tarik BenidirTarik Benidir , Andrew WoodAndrew Wood , Zaeem LoneZaeem Lone , Ao ZhangAo Zhang , Onuralp ErgunOnuralp Ergun , Caleb CurryCaleb Curry , Patrick MichaelPatrick Michael , Jay ChavaliJay Chavali , Samuel HaywoodSamuel Haywood , Zeyad SchwenZeyad Schwen , Ruben OlivaresRuben Olivares , Jihad KaoukJihad Kaouk , Robert AbouassalyRobert Abouassaly , Eric KleinEric Klein , and Christopher WeightChristopher Weight View All Author Informationhttps://doi.org/10.1097/01.JU.0001008556.20565.76.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Initial studies demonstrated that IsoPSA outperformed total and percent-free PSA in detecting clinically significant prostate cancer (csPCa), defined as grade group (GG) ≥2 on biopsy, and can lead to an overall reduction in invasive testing and magnetic resonance imaging (MRI). We sought to compare the rate of csPCa in patients with an initially normal or high IsoPSA, thus assessing IsoPSA's prospective predictive ability for csPCa. METHODS: We performed a single-center retrospective review of patients (n=1578) who underwent IsoPSA testing from November 2016 to August 2022. Data was dichotomized into patients with normal (≤6) and high IsoPSA (>6). We collected the following outcomes: subsequent IsoPSA and PSA tests, prostate biopsy , prostate MRI and diagnosis of prostate cancer. In the case of multiple follow-up tests, the most recent one was recorded. We generated survival curves depicting baseline IsoPSA's ability to predict the development of csPCa. RESULTS: The median follow-up time of 1578 patients who underwent IsoPSA testing was 24 months (interquartile range 16-29). Among 541 patients with an initial normal IsoPSA, 60 (11.1%) had a subsequent high IsoPSA, 23 (4.3%) had csPCa on a subsequent biopsy, and 48 (8.9%) had suspicious lesions on MRI (PI-RADS 4-5). Among 1037 patients with an initial high IsoPSA, 366 (35.3%) had csPCa on a subsequent biopsy and 342 (33%) had suspicious lesions on MRI. The sensitivity of IsoPSA to predict csPCa was 94.1%, and its negative predictive value was 89.3%. At 24 months, patients with a normal IsoPSA had a 2.5% risk of having a subsequent csPCa (95% confidence interval 1.4%-4.4%). Patients with an elevated IsoPSA had a 29.9% risk of having a subsequent csPCa (95% CI 26.7%-33.4%). CONCLUSIONS: With a 24-month follow-up, 4.3% of patients with normal IsoPSA developed csPCa, suggesting that a low baseline IsoPSA provides durable information about the 2-year risk of csPCa. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e543 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Nour Abdallah More articles by this author Rebecca Campbell More articles by this author Tarik Benidir More articles by this author Andrew Wood More articles by this author Zaeem Lone More articles by this author Ao Zhang More articles by this author Onuralp Ergun More articles by this author Caleb Curry More articles by this author Patrick Michael More articles by this author Jay Chavali More articles by this author Samuel Haywood More articles by this author Zeyad Schwen More articles by this author Ruben Olivares More articles by this author Jihad Kaouk More articles by this author Robert Abouassaly More articles by this author Eric Klein More articles by this author Christopher Weight More articles by this author Expand All Advertisement PDF downloadLoading ...