Pd19-08 Eau Risk Stratification for Prostate Cancer According to Systematic Biopsy, Target Biopsy and Combined Biopsy Results and Final Pathology Concordance. Results From the Promod Study Group

You have accessJournal of UrologyProstate Cancer: Detection & Screening II (PD19)1 May 2024PD19-08 EAU RISK STRATIFICATION FOR PROSTATE CANCER ACCORDING TO SYSTEMATIC BIOPSY, TARGET BIOPSY AND COMBINED BIOPSY RESULTS AND FINAL PATHOLOGY CONCORDANCE. RESULTS FROM THE PROMOD STUDY GROUP Antonella Ninivaggi, Ugo Giovanni Falagario, Angelo Cormio, Andrea Benedetto Galosi, Luca Carmignani, Emanuele Montanari, Pierluigi Bove, Paolo Gontero, Francesco Porpiglia, Alessandro Sciarra, Carlo Trombetta, Pierfrancesco Bassi, Giuseppe Simone, Giuseppe Ludovico, Vincenzo Mirone, Alessandro Antonelli, Luigi Schips, Anna Ricapito, Gian Maria Busetto, Vincenzo Ficarra, Peter J. Boström, Ottavio De Cobelli, Luigi Cormio, and Giuseppe Carrieri Antonella NinivaggiAntonella Ninivaggi , Ugo Giovanni FalagarioUgo Giovanni Falagario , Angelo CormioAngelo Cormio , Andrea Benedetto GalosiAndrea Benedetto Galosi , Luca CarmignaniLuca Carmignani , Emanuele MontanariEmanuele Montanari , Pierluigi BovePierluigi Bove , Paolo GonteroPaolo Gontero , Francesco PorpigliaFrancesco Porpiglia , Alessandro SciarraAlessandro Sciarra , Carlo TrombettaCarlo Trombetta , Pierfrancesco BassiPierfrancesco Bassi , Giuseppe SimoneGiuseppe Simone , Giuseppe LudovicoGiuseppe Ludovico , Vincenzo MironeVincenzo Mirone , Alessandro AntonelliAlessandro Antonelli , Luigi SchipsLuigi Schips , Anna RicapitoAnna Ricapito , Gian Maria BusettoGian Maria Busetto , Vincenzo FicarraVincenzo Ficarra , Peter J. BoströmPeter J. Boström , Ottavio De CobelliOttavio De Cobelli , Luigi CormioLuigi Cormio , and Giuseppe CarrieriGiuseppe Carrieri View All Author Informationhttps://doi.org/10.1097/01.JU.0001009448.41537.64.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In recent years, MRI and MRI-targeted biopsy (TB) have been proven to outperform systematic biopsy (SB) alone for the diagnosis of clinically significant prostate cancer (csPCa). Nevertheless, currently available Prostate cancer (PCa) risk stratification group systems are based on SB alone and the implications of the addition of target biopsies into such risk stratifications is unknown.Waiting long term outcomes of contemporary cohorts diagnosed with TB only and TB+SB, the aim of this study was to quantify stage migration within EAU risk groups based on SB, TB and combined biopsy and to compare it with final pathology ground truth. METHODS: We retrospectively reviewed the Prostate Mri Outcome Database (PROMOD) including all men with clinical suspicion of PCa undergoing prostate biopsy with a positive MRI (PIRADS≥3) at 24 institutions between 2013 and 2022. All patients underwent TB+SB. We included only patients who underwent radical prostatectomy. EAU risk groups at diagnosis were computed according to results of SB alone, TB alone and combined biopsy. RESULTS: 1607 patients were included. According to EAU risk stratification for PCa, if only SB was performed, 19%, 45% and 14% of patients would have been diagnosed with low risk, intermediate risk and high-risk PCa, respectively. Otherwise, if TB was performed alone, 16% would have had a diagnosis of low-risk PCa, 53% of intermediate-risk PCa and 17% of high-risk PCa. The combination of SB+TB resulted in a diagnosis of low-risk PCa in 19%, intermediate-risk PCa in 59% and high-risk PCa in 21% of patients. Final pathology concordance was 56% in SB group, 65% in TB group and 75% in SB+TB group. An upgrading at RP specimen was found in 17%, 16% and 17% of patients who underwent SB only, TB only and SB+TB respectively. Particularly noteworthy is how only 6% of low-risk patients at SB+TB upgraded to high-risk group at final pathology. Moreover, 345 patients and 232 patients would have missed PCa if SB only and TB only, respectively, had been performed. Among these patients, 26.4% with a negative SB and 29% with a negative TBx had high risk PCa at final pathology. CONCLUSIONS: EAU risk stratification based on the combination of SB and TB associates better with final pathology resulting in a higher concordance rate when compared to SB and TB only. Additionally, we didn't find any significant downgrading from intermediate risk at TB to low risk at final pathology. Based on these findings SB and TB should always be performed to better predict final pathology. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e443 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Antonella Ninivaggi More articles by this author Ugo Giovanni Falagario More articles by this author Angelo Cormio More articles by this author Andrea Benedetto Galosi More articles by this author Luca Carmignani More articles by this author Emanuele Montanari More articles by this author Pierluigi Bove More articles by this author Paolo Gontero More articles by this author Francesco Porpiglia More articles by this author Alessandro Sciarra More articles by this author Carlo Trombetta More articles by this author Pierfrancesco Bassi More articles by this author Giuseppe Simone More articles by this author Giuseppe Ludovico More articles by this author Vincenzo Mirone More articles by this author Alessandro Antonelli More articles by this author Luigi Schips More articles by this author Anna Ricapito More articles by this author Gian Maria Busetto More articles by this author Vincenzo Ficarra More articles by this author Peter J. Boström More articles by this author Ottavio De Cobelli More articles by this author Luigi Cormio More articles by this author Giuseppe Carrieri More articles by this author Expand All Advertisement PDF downloadLoading ...