Significant prostate cancer risk after MRI-guided biopsy showing benign findings: Results from a cohort of 381 men.

IF 0.8 4区医学 Q4 UROLOGY & NEPHROLOGY Progres En Urologie Pub Date : 2024-01-01 Epub Date: 2023-10-17 DOI:10.1016/j.purol.2023.10.001

V T Dang, S Péricart, C Manceau, R Aziza, D Portalez, S Lagarde, M Soulié, X Gamé, B Malavaud, M Thoulouzan, N Doumerc, T Prudhomme, G Ploussard, M Roumiguié

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Abstract

Background: MRI-guided biopsy (MGB) contributes to the diagnosis of clinically significant Prostate Cancer (csPCa). However, there are no clear recommendations for the management of men after a negative MGB. The aim of this study was to assess the risk of csPCa after a first negative MGB.

Methods: Between 2014 and 2020, we selected men with a PI-RADS score ≥ 3 on MRI and a negative MGB (showing benign findings) performed for suspected prostate cancer. MGB (targeted and systematic biopsies) was performed using fully integrated mobile fusion imaging (KOELIS). The primary endpoint was the rate of csPCa (defined as an ISUP grade ≥ 2) diagnosed after a first negative MGB.

Results: A total of 381 men with a negative MGB and a median age of 65 (IQR: 59-69, range: 46-85) years were included. During the median follow-up of 31 months, 124 men (32.5%) had a new MRI, and 76 (19.9%) were referred for a new MGB, which revealed csPCa in 16 (4.2%) of them. We found no statistical difference in the characteristics of men diagnosed with csPCa compared with men with no csPCa after the second MGB.

Conclusion: We observed a risk of significant prostate cancer in 4% of men two years after a negative MRI-guided biopsy. Performing a repeat MRI could improve the selection of men who will benefit from a repeat MRI-guided biopsy, but a clear protocol is needed to follow these patients.

Level of evidence: 4:

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MRI引导的活检显示良性结果后，显著的前列腺癌症风险：来自381名男性的队列研究结果。

背景：磁共振成像引导活检（MGB）有助于诊断具有临床意义的癌症（csPCa）。然而，对于阴性MGB后的男性管理，没有明确的建议。本研究的目的是评估首次阴性MGB后发生csPCa的风险。方法：在2014年至2020年间，我们选择了MRI PI-RADS评分≥3，MGB阴性（显示良性结果）的男性，对疑似前列腺癌症进行检查。MGB（靶向和系统活检）使用完全集成的移动融合成像（KOELIS）进行。主要终点是首次MGB阴性后诊断为csPCa（定义为ISUP≥2级）的比率。结果：共纳入381名MGB阴性、中位年龄65岁（IQR:59-69，范围：46-85）的男性。在31个月的中位随访中，124名男性（32.5%）接受了新的MRI检查，76名男性（19.9%）被转诊接受新的MGB检查，其中16名男性（4.2%）出现csPCa。在第二次MGB后，我们发现诊断为csPCa的男性与未诊断为csPCa的男性的特征没有统计学差异。结论：我们观察到，在MRI引导的阴性活检后两年，4%的男性有患显著前列腺癌症的风险。进行重复MRI可以改善从重复MRI引导的活检中受益的男性的选择，但需要一个明确的方案来跟踪这些患者。证据级别：4:

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Progres En Urologie 医学-泌尿学与肾脏学

CiteScore

1.80

自引率

27.30%

发文量

132

审稿时长

54 days

期刊介绍： Une publication rapide des travaux en urologie: retrouvez les derniers travaux de recherche, études et enquêtes, en Urologie, publiés sous la forme de revues, mises au point, articles originaux, notes techniques, cas cliniques pertinents et originaux, lettres à la rédaction, revues de la littérature, textes de recommandation,... La revue publie également des articles pour les infirmières en Urologie. Une approche pluridisciplinaire : Progrès en Urologie aborde toutes les pathologies urologiques. Aux 13 numéros de Progrès viennent s''ajouter 4 numéros de Progrès en Urologie Pelvi-Périnéologie