- In patients with low-risk prostate cancer, MRI-guided confirmatory biopsy findings are associated with future risk of disease upgrade.
- Adopting only targeted or systematic biopsy can miss up to 45% of upgrades.
Why this matters
- MRI-guided confirmatory biopsy is an appropriate entry point for active surveillance.
- Study of 332 men with Gleason grade group (GG) ≤2 prostate cancer undergoing active surveillance.
- Confirmatory MRI-guided biopsy was performed within 1 year of initial diagnostic biopsy.
- Funding: National Cancer Institute.
- 114 patients had normal findings on confirmatory biopsy, 175 had GG1 disease, and 43 had GG2 disease.
- Median follow up: 3.9 years.
- 11.7% of patients upgraded to GG≥3 disease (confirmatory biopsy findings: normal, 7.9%; GG1, 11.4%; GG2, 23.3% [P=.03]).
- In patients with low PSA density (
- GG1 disease also increased upgrade risk (HR, 3.3; 95% CI, 1.3-8.4).
- Retrospective design.