Mp25-02 Metrics of Treatment Outcome Following Partial Gland Ablation for Prostate Cancer: Psa, Mri, or Biopsy?

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy I (MP25)1 May 2024MP25-02 METRICS OF TREATMENT OUTCOME FOLLOWING PARTIAL GLAND ABLATION FOR PROSTATE CANCER: PSA, MRI, OR BIOPSY? Wayne Brisbane, Shannon Richardson, Adam Kinnaird, Lorna Kwan, Samantha Gonzalez, Alan M. Priester, Ely R. Felker, Anthony E. Sisk, Merdie Delfin, and Leonard S. Marks Wayne BrisbaneWayne Brisbane , Shannon RichardsonShannon Richardson , Adam KinnairdAdam Kinnaird , Lorna KwanLorna Kwan , Samantha GonzalezSamantha Gonzalez , Alan M. PriesterAlan M. Priester , Ely R. FelkerEly R. Felker , Anthony E. SiskAnthony E. Sisk , Merdie DelfinMerdie Delfin , and Leonard S. MarksLeonard S. Marks View All Author Informationhttps://doi.org/10.1097/01.JU.0001008692.26556.39.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We tested the hypothesis that changes in MRI or PSA following focal therapy (FT) of prostate cancer (PCa) could replace biopsy in assessment of treatment outcome. METHODS: Subjects were all 309 men with GG2 (69%) or GG3 (31%) PCa who underwent FT from 2016 to 2022 in prospective trials of High Intensity Focused Ultrasound (HIFU; NCT03620786), N=90, or cryotherapy (CRYO; NCT03503643), N=219. PSA ≥GG2) on follow-up (f/u) MRGB; concordance of biopsy with MRI (+/- lesions) 77% were White, 5% Black, 18% other/NA. At baseline, MRI lesions (PIRADS 3-5) were present in 236 men; median PSA was 6.6 (IQR 4.7, 9.8). At 6 months after FT, csPCa was absent in 188 (72%) (successful FT) and still present in 73 (28%) (failed FT) (Table 1). Among successes, MRI lesions were no longer present in 147/187 (79%); among failures, lesions were no longer present in 47/65 (72%) (p=0.13) (Table 1). PSA decreased by >50% in most successes (127/190; 67%) and also in most failures (37/68; 54%) (p=0.57). Sensitivity of MRI was 28% and specificity was 79%. Sensitivity of PSA was 46% and specificity 67%. Similar results were seen at 2nd f/u biopsy (Table 1). CRYO and HIFU treatment results were comparable. When change in either MRI or PSA suggested absence of csPCa, the combined sensitivity was 73% and specificity was 75%. CONCLUSIONS: After FT, presence of residual csPCa is best determined by MRGB, rather than by indirect metrics, i.e., PSA or MRI. FT energy appears to have a suppressant effect on the prostate markers independent of the anti-neoplastic effect. Download PPT Source of Funding: This work was supported in part by grants R01CA158627 and R01CA218547 from the National Cancer Institute; grant UL1TR000124 from University of California, Los Angeles (UCLA) Clinical and Translational Science Institute © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e403 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Wayne Brisbane More articles by this author Shannon Richardson More articles by this author Adam Kinnaird More articles by this author Lorna Kwan More articles by this author Samantha Gonzalez More articles by this author Alan M. Priester More articles by this author Ely R. Felker More articles by this author Anthony E. Sisk More articles by this author Merdie Delfin More articles by this author Leonard S. Marks More articles by this author Expand All Advertisement PDF downloadLoading ...