دورية أكاديمية
Upgrading on Per Protocol versus For Cause surveillance prostate biopsies: An opportunity to decreasing the burden of active surveillance.
| العنوان: | Upgrading on Per Protocol versus For Cause surveillance prostate biopsies: An opportunity to decreasing the burden of active surveillance. |
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| المؤلفون: | Wang M; Department of Urology, Wayne State University, Detroit, Michigan, USA., Lange A; Department of Urology, Wayne State University, Detroit, Michigan, USA., Perlman D; Department of Urology, Wayne State University, Detroit, Michigan, USA., Qi J; University of Michigan Medical School, Ann Arbor, Michigan, USA., George AK; University of Michigan Medical School, Ann Arbor, Michigan, USA., Ferrante S; University of Michigan Medical School, Ann Arbor, Michigan, USA., Semerjian A; IHA Urology, St. Joseph Mercy Hospital, Ann Arbor, Michigan, USA., Sarle R; Department of Urology, Sparrow Point Hospitals, Lansing, Michigan, USA., Cher ML; Department of Urology, Wayne State University, Detroit, Michigan, USA., Ginsburg KB; Department of Urology, Wayne State University, Detroit, Michigan, USA. |
| مؤلفون مشاركون: | Michigan Urological Surgery Improvement Collaborative; University of Michigan Medical School, Ann Arbor, Michigan, USA. |
| المصدر: | The Prostate [Prostate] 2023 Sep; Vol. 83 (12), pp. 1141-1149. Date of Electronic Publication: 2023 May 12. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wiley-Liss Country of Publication: United States NLM ID: 8101368 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-0045 (Electronic) Linking ISSN: 02704137 NLM ISO Abbreviation: Prostate Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2005-> : Hoboken, NJ : Wiley-Liss Original Publication: New York : Alan R. Liss, c1980- |
| مواضيع طبية MeSH: | Prostate*/diagnostic imaging , Prostate*/pathology , Prostatic Neoplasms*/diagnostic imaging , Prostatic Neoplasms*/pathology, Male ; Humans ; Prostate-Specific Antigen ; Retrospective Studies ; Watchful Waiting/methods ; Image-Guided Biopsy/methods ; Biopsy ; Magnetic Resonance Imaging/methods ; Neoplasm Grading |
| مستخلص: | Background: Most prostate cancer (PC) active surveillance (AS) protocols recommend "Per Protocol" surveillance biopsy (PPSBx) every 1-3 years, even if clinical and imaging parameters remained stable. Herein, we compared the incidence of upgrading on biopsies that met criteria for "For Cause" surveillance biopsy (FCSBx) versus PPSBx. Methods: We retrospectively reviewed men with GG1 PC on AS in the Michigan Urological Surgery Improvement Collaborative (MUSIC) registry. Surveillance prostate biopsies obtained 1 year after diagnosis were classified as either PPSBx or FCSBx. Biopsies were retrospectively deemed FCSBx if any of these criteria were met: PSA velocity > 0.75 ng/mL/year; rise in PSA > 3 ng from baseline; surveillance magnetic resonance imaging (MRI) (sMRI) with a PIRADS ≥ 4; change in DRE. Biopsies were classified PPSBx if none of these criteria were met. The primary outcome was upgrading to ≥GG2 or ≥GG3 on surveillance biopsy. The secondary objective was to assess for the association of reassuring (PIRADS ≤ 3) confirmatory or surveillance MRI findings and upgrading for patients undergoing PPSBx. Proportions were compared with the chi-squared test. Results: We identified 1773 men with GG1 PC in MUSIC who underwent a surveillance biopsy. Men meeting criteria for FCSBx had more upgrading to ≥GG2 (45%) and ≥GG3 (12%) compared with those meeting criteria for PPSBx (26% and 4.9%, respectively, p < 0.001 and p < 0.001). Men with a reassuring confirmatory or surveillance MRI undergoing PPSBx had less upgrading to ≥GG2 (17% and 17%, respectively) and ≥GG3 (2.9% and 1.8%, respectively) disease compared with men without an MRI (31% and 7.4%, respectively). Conclusions: Patients undergoing PPSBx had significantly less upgrading compared with men undergoing FCSBx. Confirmatory and surveillance MRI seem to be valuable tools to stratify the intensity of surveillance biopsies for men on AS. These data may help inform the development of a risk-stratified, data driven AS protocol. (© 2023 Wiley Periodicals LLC.) |
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| فهرسة مساهمة: | Keywords: MRI; active surveillance; genomic classifier; prostate biopsy; prostate cancer |
| المشرفين على المادة: | EC 3.4.21.77 (Prostate-Specific Antigen) |
| تواريخ الأحداث: | Date Created: 20230512 Date Completed: 20230724 Latest Revision: 20230725 |
| رمز التحديث: | 20230725 |
| DOI: | 10.1002/pros.24556 |
| PMID: | 37173808 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1097-0045 |
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| DOI: | 10.1002/pros.24556 |