دورية أكاديمية
أعرض في EDS

Prostate cancer upgrading with serial prostate magnetic resonance imaging and repeat biopsy in men on active surveillance: are confirmatory biopsies still necessary?

التفاصيل البيبلوغرافية
العنوان: Prostate cancer upgrading with serial prostate magnetic resonance imaging and repeat biopsy in men on active surveillance: are confirmatory biopsies still necessary?
المؤلفون: Osses DF; Departments of, Department of, Radiology & Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.; Department of, Urology, Erasmus University Medical Center, Rotterdam, The Netherlands., Drost FH; Departments of, Department of, Radiology & Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.; Department of, Urology, Erasmus University Medical Center, Rotterdam, The Netherlands., Verbeek JFM; Department of, Urology, Erasmus University Medical Center, Rotterdam, The Netherlands., Luiting HB; Department of, Urology, Erasmus University Medical Center, Rotterdam, The Netherlands., van Leenders GJLH; Department of, Pathology, Erasmus University Medical Center, Rotterdam, The Netherlands., Bangma CH; Department of, Urology, Erasmus University Medical Center, Rotterdam, The Netherlands., Krestin GP; Departments of, Department of, Radiology & Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands., Roobol MJ; Department of, Urology, Erasmus University Medical Center, Rotterdam, The Netherlands., Schoots IG; Departments of, Department of, Radiology & Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
المصدر: BJU international [BJU Int] 2020 Jul; Vol. 126 (1), pp. 124-132. Date of Electronic Publication: 2020 Apr 22.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Blackwell Science Country of Publication: England NLM ID: 100886721 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1464-410X (Electronic) Linking ISSN: 14644096 NLM ISO Abbreviation: BJU Int Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Oxford, UK : Blackwell Science, c1999-
مواضيع طبية MeSH: Biopsy/*methods , Image-Guided Biopsy/*methods , Magnetic Resonance Imaging/*methods , Neoplasm Staging/*methods , Prostate/*pathology , Prostatic Neoplasms/*diagnosis, Aged ; Humans ; Male ; Middle Aged ; Retrospective Studies
مستخلص: Objectives: To investigate whether serial prostate magnetic resonance imaging (MRI) may guide the utility of repeat targeted (TBx) and systematic biopsy (SBx) when monitoring men with low-risk prostate cancer (PCa) at 1-year of active surveillance (AS).
Patients and Methods: We retrospectively included 111 consecutive men with low-risk (International Society of Urological Pathology [ISUP] Grade 1) PCa, who received protocolled repeat MRI with or without TBx and repeat SBx at 1-year of AS. TBx was performed in Prostate Imaging-Reporting and Data System (PI-RADS) score ≥3 lesions (MRI-positive men). Upgrading defined as ISUP Grade ≥2 PCa (I), Grade ≥2 with cribriform growth/intraductal carcinoma PCa (II), and Grade ≥3 PCa (III) was investigated. Upgrading detected by TBx only (not by SBx) and SBx only (not by TBx) was investigated in MRI-positive and -negative men, and related to radiological progression on MRI (Prostate Cancer Radiological Estimation of Change in Sequential Evaluation [PRECISE] score).
Results: Overall upgrading (I) was 32% (35/111). Upgrading in MRI-positive and -negative men was 48% (30/63) and 10% (5/48) (P < 0.001), respectively. In MRI-positive men, there was upgrading in 23% (seven of 30) by TBx only and in 33% (10/30) by SBx only. Radiological progression (PRECISE score 4-5) in MRI-positive men was seen in 27% (17/63). Upgrading (I) occurred in 41% (seven of 17) of these MRI-positive men, while this was 50% (23/46) in MRI-positive men without radiological progression (PRECISE score 1-3) (P = 0.534). Overall upgrading (II) was 15% (17/111). Upgrading in MRI-positive and -negative men was 22% (14/63) and 6% (three of 48) (P = 0.021), respectively. In MRI-positive men, there was upgrading in three of 14 by TBx only and in seven of 14 by SBx only. Overall upgrading (III) occurred in 5% (five of 111). Upgrading in MRI-positive and -negative men was 6% (four of 63) and 2% (one of 48) (P = 0.283), respectively. In MRI-positive men, there was upgrading in one of four by TBx only and in two of four by SBx only.
Conclusion: Upgrading is significantly lower in MRI-negative compared to MRI-positive men with low-risk PCa at 1-year of AS. In serial MRI-negative men, the added value of repeat SBx at 1-year surveillance is limited and should be balanced individually against the harms. In serial MRI-positive men, the added value of repeat SBx is substantial. Based on this cohort, SBx is recommended to be performed in combination with TBx in all MRI-positive men at 1-year of AS, also when there is no radiological progression.
(© 2020 The Authors BJU International Published by John Wiley & Sons Ltd on behalf of BJU International.)
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فهرسة مساهمة: Keywords: #PCSM; #ProstateCancer; PI-RADS; PRECISE; active surveillance; low-risk prostate cancer; prostate MRI; upgrading
تواريخ الأحداث: Date Created: 20200402 Date Completed: 20201130 Latest Revision: 20201130
رمز التحديث: 20240829
مُعرف محوري في PubMed: PMC7383866
DOI: 10.1111/bju.15065
PMID: 32232921
قاعدة البيانات: MEDLINE
الوصف
تدمد:1464-410X
DOI:10.1111/bju.15065