Mp31-09 Comparing Cancer Detection Between Transrectal and Transperineal Prostate Biopsy in an Active Surveillance Cohort

You have accessJournal of UrologyProstate Cancer: Detection & Screening III (MP31)1 May 2024MP31-09 COMPARING CANCER DETECTION BETWEEN TRANSRECTAL AND TRANSPERINEAL PROSTATE BIOPSY IN AN ACTIVE SURVEILLANCE COHORT Sunny Nalavenkata, Chris Gaffney, Amy Tin, Andrew Vickers, and Behfar Ehdaie Sunny NalavenkataSunny Nalavenkata , Chris GaffneyChris Gaffney , Amy TinAmy Tin , Andrew VickersAndrew Vickers , and Behfar EhdaieBehfar Ehdaie View All Author Informationhttps://doi.org/10.1097/01.JU.0001008936.35187.0b.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Transperineal prostate biopsy (TP) is increasingly preferred over transrectal biopsy (TR) due to the decreased risk of infection. Data on relative cancer detection rates remains incomplete. We analyzed our large institutional dataset to assess biopsy outcome for TP and TR biopsies in terms of cancer detection and location of disease. METHODS: All patients on active surveillance undergoing prostate biopsy at MSKCC during the 26 month transition period from TR to TP were included. Data collected included patient demographics, biopsy data (approach, number of prior biopsies, cores, systematic vs target), histopathology (highest previously diagnosed ISUP grade, grade from biopsy) and imaging findings (MRI PIRADS score (1-5) prior to biopsy). Multivariable logistic regression was performed with the primary outcome of high-grade cancer on biopsy (defined as biopsy Gleason Grade Group (GG) ≥2), adjusted for patient, biopsy and imaging variables. A similar approach was used for the secondary outcomes of overdiagnosis of GG1 disease and disease location. Clustered standard errors were used for patients undergoing repeat biopsies. RESULTS: We identified 1388 biopsies performed on 1305 patients at MSK from January 2020 to February 2023. Characteristics based on biopsy type are shown in the Table 1. Among all biopsies, 523 (38%) were high grade and 602 (43%) were GG1. Detection of high grade cancer was slightly and non-significantly lower in TP (OR 0.87, 95% CI 0.66, 1.14, p-value=0.3). There was evidence that TP reduced overdiagnosis of GG1 disease (OR vs Benign or high-grade cancer 0.75, 95% CI 0.58, 0.97, p-value = 0.029; OR vs Benign, after excluding biopsies with high grade disease 0.54, 95% CI 0.38, 0.76, p-value<0.001). TP had a higher yield for anterior disease compared to with the TB (21% vs 9%, <0.001) but a lower yield of posterior disease (29% vs. 34%, p=0.059). CONCLUSIONS: TP can be used to reduce risk of infection without concerns about detection of high-grade disease. Further research is required to evaluate tumor location and overdetection GG1 disease as our findings may reflect temporal trends during the period of transition to TP. Source of Funding: Nil © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e507 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Sunny Nalavenkata More articles by this author Chris Gaffney More articles by this author Amy Tin More articles by this author Andrew Vickers More articles by this author Behfar Ehdaie More articles by this author Expand All Advertisement PDF downloadLoading ...