Key points are not available for this paper at this time.
Background: Men after an initial negative transrectal ultrasound (TRUS)-guided prostate biopsy have a low risk of prostate cancer (PCa) diagnosis and mortality during follow-up. It is unknown whether an initial negative multi-parametric magnetic resonance imaging (mpMRI)-guided biopsy is associated with the same risk of PCa diagnosis and mortality during follow-up. The present study aimed to describe the risk differences of developing localized, metastatic or deadly PCa after either a negative TRUS or mpMRI-guided prostate biopsy. Methods: Men after an initial negative prostate biopsy at our institution between 2005–2021 were retrospectively identified and divided into two groups, whether they received an mpMRI prior to the biopsy magnetic resonance imaging (MRI) group or not (no MRI group). Categorical and continuous variables were compared by t-tests. Results: A total of 1,308 men underwent an initial negative prostate biopsy (84% TRUS; 16% MRI). Re-biopsies were significantly more often performed in the no MRI group (P value <0.001). The incidence rate (IR) of PCa (grade group ≥2) were 9.8 per 1,000 person-years (py) in the no MRI group and 11.9 per 1,000 py in the MRI group (P value =0.50). No metastasis or PCa specific deaths were recorded in the MRI group, whereas the IR were 1.19 and 0.17 per 1,000 py in the no MRI group. Conclusions: Men with an initial negative biopsy have a low risk of developing localized, metastatic, or deadly PCa during long-term follow-up. The biopsy technique was not significantly associated with different IRs of significant PCa diagnoses. The event rates of metastasis and PCa-specific deaths were too rare to draw any conclusions.
Scherer et al. (Mon,) studied this question.