Mp25-05 Impact of Mri Visibility of Prostate Cancer on Oncological Outcomes in Focal Therapy

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy I (MP25)1 May 2024MP25-05 IMPACT OF MRI VISIBILITY OF PROSTATE CANCER ON ONCOLOGICAL OUTCOMES IN FOCAL THERAPY Masatomo Kaneko, Lorenzo Storino Ramacciotti, Divyangi Paralkar, Samuel Peretsman, Jessica Brooks, Giovanni E. Cacciamani, Michelle Hopstone, Manju Aron, Osamu Ukimura, Inderbir S. Gill, and Andre Luis Abreu Masatomo KanekoMasatomo Kaneko , Lorenzo Storino RamacciottiLorenzo Storino Ramacciotti , Divyangi ParalkarDivyangi Paralkar , Samuel PeretsmanSamuel Peretsman , Jessica BrooksJessica Brooks , Giovanni E. CacciamaniGiovanni E. Cacciamani , Michelle HopstoneMichelle Hopstone , Manju AronManju Aron , Osamu UkimuraOsamu Ukimura , Inderbir S. GillInderbir S. Gill , and Andre Luis AbreuAndre Luis Abreu View All Author Informationhttps://doi.org/10.1097/01.JU.0001008692.26556.39.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To evaluate the oncological outcomes of focal therapy (FT) according to prostate cancer (PCa) visibility on magnetic resonance imaging (MRI). METHODS: Consecutive patients who underwent MRI-informed prostate biopsy (PBx) followed by hemi-gland Cryoablation (CRYO) or High-Intensity Focused Ultrasound (HIFU) for PCa were identified from a multicentric database (IRB# HS-17-00749). The surveillance after FT included PSA every 3-6M, MRI every 12M, and mandatory follow up PBx (FU-PBx) at 12M and every 2yr thereafter. Lesion visibility was defined as Prostate Imaging–Reporting and Data System (PIRADS) ≥4. The primary endpoint was treatment failure (TF) defined as Grade Group (GG) ≥2 on FU-PBx, any whole-gland treatment, systemic therapy, metastases, or PCa-specific mortality. Secondary endpoints were survival-free from I) Biochemical Failure (BF, PSA nadir + 2ng/mL); II) GG≥2 on FU-PBx, and III) Radical Treatment. Kaplan-Meier and Cox regression analyses were performed. Statistically significant if p<0.05. RESULTS: A total of 156 patients met the inclusion criteria with 97 (62%) visible and 59 (38%) invisible PCa on baseline MRI. The patients with MRI visible PCa showed an older median age (64 vs 62yr, p=0.04), higher PSA density (PSAD, 0.18 vs 0.13 ng/mL2, p=0.001), similar follow up (23 vs 32M, p=0.08), similar distribution of treatment modality: CRYO (23 vs 15%), HIFU (77 vs 85%), higher distribution of GG2-3: GG1 (18 vs 36%), GG2-3 (81 vs 59%), and GG4-5 (1.0 vs 5.1%) (p=0.009), and higher distribution of intermediate risk PCa, as follows: low (15 vs 36%), intermediate (81 vs 59%), and high (3.1 vs 5.1%) (p=0.01) than invisible cases, respectively. The 3-year free-survival rates were, for visible vs invisible: TF (57% vs 82%, p=0.004); BF (80% vs 74%, p=0.7); GG≥2 on FU-PBx (58% vs 84%, p=0.003); and Radical Treatment (87% vs 85%, p=1.0), respectively. Lesion visibility (hazard ratio HR 4.83, 95% confidence interval 95%CI 1.81-12.90), PSAD per 0.01 (HR 1.03, 95%CI 1.002-1.05), and nadir PSA reduction (%) (HR 0.97, 95%CI 0.95-0.98) were independent predictors for TF (Table 1). CONCLUSIONS: Patients with visible PCa on MRI have a higher risk of treatment failure when undergoing focal therapy. MRI visibility may be used as a prognosticator after focal therapy for PCa. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e405 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Masatomo Kaneko More articles by this author Lorenzo Storino Ramacciotti More articles by this author Divyangi Paralkar More articles by this author Samuel Peretsman More articles by this author Jessica Brooks More articles by this author Giovanni E. Cacciamani More articles by this author Michelle Hopstone More articles by this author Manju Aron More articles by this author Osamu Ukimura More articles by this author Inderbir S. Gill More articles by this author Andre Luis Abreu More articles by this author Expand All Advertisement PDF downloadLoading ...