Mp19-15 the Significant Added Value of Concomitant Systematic Prostate Biopsies in Addition to Targeted Sampling in Patients With Previous Negative Biopsies. Implications for Accurate Staging Predictions From a Large Multi-Institutional Series

You have accessJournal of UrologyProstate Cancer: Detection & Screening I (MP19)1 May 2024MP19-15 THE SIGNIFICANT ADDED VALUE OF CONCOMITANT SYSTEMATIC PROSTATE BIOPSIES IN ADDITION TO TARGETED SAMPLING IN PATIENTS WITH PREVIOUS NEGATIVE BIOPSIES. IMPLICATIONS FOR ACCURATE STAGING PREDICTIONS FROM A LARGE MULTI-INSTITUTIONAL SERIES Daniele Robesti, Francesco Pellegrino, Armando Stabile, Francesco Barletta, Simone Scuderi, Guillaume Ploussard, Giancarlo Marra, Massimo Valerio, Riccardo Campi, Andrea Minervini, Alessandro Marquis, Alessandro Viti, Jean-Baptiste Beauval, Arnas Rakauskas, Roderick van den Bergh, Razvan-George Rahota, Timo F. W. Soeterik, Mathieu Roumiguié, Hongqian Guo, Agostino Mattei, Paolo Gontero, Giorgio Gandaglia, Francesco Montorsi, and Alberto Briganti Daniele RobestiDaniele Robesti , Francesco PellegrinoFrancesco Pellegrino , Armando StabileArmando Stabile , Francesco BarlettaFrancesco Barletta , Simone ScuderiSimone Scuderi , Guillaume PloussardGuillaume Ploussard , Giancarlo MarraGiancarlo Marra , Massimo ValerioMassimo Valerio , Riccardo CampiRiccardo Campi , Andrea MinerviniAndrea Minervini , Alessandro MarquisAlessandro Marquis , Alessandro VitiAlessandro Viti , Jean-Baptiste BeauvalJean-Baptiste Beauval , Arnas RakauskasArnas Rakauskas , Roderick van den BerghRoderick van den Bergh , Razvan-George RahotaRazvan-George Rahota , Timo F. W. SoeterikTimo F. W. Soeterik , Mathieu RoumiguiéMathieu Roumiguié , Hongqian GuoHongqian Guo , Agostino MatteiAgostino Mattei , Paolo GonteroPaolo Gontero , Giorgio GandagliaGiorgio Gandaglia , Francesco MontorsiFrancesco Montorsi , and Alberto BrigantiAlberto Briganti View All Author Informationhttps://doi.org/10.1097/01.JU.0001008716.22569.77.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: EAU Guidelines suggest avoiding systematic biopsy (SBx) in patients with positive prostate MRI and history of previous negative biopsies (PNB). However, information provided by SBx are included in the majority of models predicting adverse pathological features, in prostate cancer (PCa) patients receiving radical prostatectomy (RP). Here, we assessed SBx added value even in the context of repeat biopsy setting for accurate stage predictions at RP. METHODS: We identified 1802 patients receiving SBx+targeted biopsy (TBx) with positive MRI (PIRADS≥3) undergoing RP between 2012-2021 at 10 tertiary referral centres. Patients were grouped according to previous biopsy history (biopsy naïve BN vs PNB). We recalculated nomograms predicting seminal vesicle invasion (SVI), extracapsular extension (ECE), and lymph node invasion (LNI) including (Model 1) and excluding SBx (Model 2). The accuracy of Model 1 vs 2 was calculated using AUC. Finally, we evaluated the net benefit of including SBx information using decision curve analyses (DCA). RESULTS: Overall, 211 (12%) patients had PNB before PCa diagnosis. SBx with hgPCa rate was higher in BN patients (25 vs 17%, p<0.01). At final pathology, there was no difference in ECE (44 vs 46%, p=0.4) and SVI (9 vs 8% p=0.5) in BN vs PNB patients. Overall, 992 patients receiving RP+PLND were used for nomogram predicting LNI analysis. Among these, 6 and 8% had pN1among BN and PNB patients (p=0.7). At MVA, the percentage of SBx with hgPCa was associated with all outcomes (OR 3.49, 4.7, and 9.46, for LNI, ECE and SVI, all p<0.05). The inclusion of SBx information increased the AUC of all models in both BN (LNI: 0.70 vs 0.72, ECE: 0.66 vs 0.68, SVI: 0.73 vs 0.76) and PNB (LNI: 0.73 vs 0.78, ECE: 0.58 vs 0.61, SVI: 0.72 vs 0.76) patients. The DCAs (Figure 1) show as the net benefit was the highest for nomograms including SBx information for all the outcomes tested. CONCLUSIONS: The inclusion of SBx information increases the accuracy of nomograms predicting LNI, ECE, and SVI after RP. Therefore, SBx should be performed also in patients with PNB in order to improve risk assessment and staging predictions. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e316 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Daniele Robesti More articles by this author Francesco Pellegrino More articles by this author Armando Stabile More articles by this author Francesco Barletta More articles by this author Simone Scuderi More articles by this author Guillaume Ploussard More articles by this author Giancarlo Marra More articles by this author Massimo Valerio More articles by this author Riccardo Campi More articles by this author Andrea Minervini More articles by this author Alessandro Marquis More articles by this author Alessandro Viti More articles by this author Jean-Baptiste Beauval More articles by this author Arnas Rakauskas More articles by this author Roderick van den Bergh More articles by this author Razvan-George Rahota More articles by this author Timo F. W. Soeterik More articles by this author Mathieu Roumiguié More articles by this author Hongqian Guo More articles by this author Agostino Mattei More articles by this author Paolo Gontero More articles by this author Giorgio Gandaglia More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Expand All Advertisement PDF downloadLoading ...