Academic Journal
Magnetic Resonance Imaging-guided Active Surveillance Without Annual Rebiopsy in Patients with Grade Group 1 or 2 Prostate Cancer: The Prospective PROMM-AS Study
| Title: | Magnetic Resonance Imaging-guided Active Surveillance Without Annual Rebiopsy in Patients with Grade Group 1 or 2 Prostate Cancer: The Prospective PROMM-AS Study |
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| Authors: | Birte Valentin, Christian Arsov, Tim Ullrich, Rouvier Al-Monajjed, Matthias Boschheidgen, Boris A. Hadaschik, Francesco Giganti, Markus Giessing, Cristina Lopez-Cotarelo, Irene Esposito, Gerald Antoch, Peter Albers, Jan Philipp Radtke, Lars Schimmöller |
| Source: | European Urology Open Science, Vol 59, Iss , Pp 30-38 (2024) |
| Publisher Information: | Elsevier, 2024. |
| Publication Year: | 2024 |
| Collection: | LCC:Diseases of the genitourinary system. Urology LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens |
| Subject Terms: | Prostate cancer, Magnetic resonance imaging, Transrectal ultrasound fusion-guided biopsy, Active surveillance, Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE), Diseases of the genitourinary system. Urology, RC870-923, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282 |
| More Details: | Background: Multiparametric magnetic resonance imaging (mpMRI) may allow patients with prostate cancer (PC) on active surveillance (AS) to avoid repeat prostate biopsies during monitoring. Objective: To assess the ability of mpMRI to reduce guideline-mandated biopsy and to predict grade group upgrading in patients with International Society of Urological Pathology grade group (GG) 1 or GG 2 PC using Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) scores. The hypothesis was that the AS disqualification rate (ASDQ) rate could be reduced to 15%. Design, setting and participants: PROMM-AS was a prospective study assessing 2-yr outcomes for an mpMRI-guided AS protocol. A 12 mo after AS inclusion on the basis of MRI/transrectal ultrasound fusion-guided biopsy (FBx), all patients underwent mpMRI. For patients with stable mpMRI (PRECISE 1–3), repeat biopsy was deferred and follow-up mpMRI was scheduled for 12 mo later. Patients with mpMRI progression (PRECISE 4–5) underwent FBx. At the end of the study, follow-up FBx was indicated for all patients. Outcome measurements and statistical analysis: We calculated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for upgrading to GG 2 in the GG 1 group, and to GG 3 in the GG 2 group on MRI. We performed regression analyses that included clinical variables. Results and limitations: The study included 101 patients with PC (60 GG 1 and 41 GG 2). Histopathological progression occurred in 31 patients, 18 in the GG 1 group and 13 in the GG 2 group. Thus, the aim of reducing the ASDQ rate to 15% was not achieved. The sensitivity, specificity, PPV, and NPV for PRECISE scoring of MRI were 94%, 64%, 81%, and 88% in the GG 1 group, and 92%, 50%, 92%, and 50%, respectively, in the GG 2 group. On regression analysis, initial prostate-specific antigen (p |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 2666-1683 |
| Relation: | http://www.sciencedirect.com/science/article/pii/S2666168323017986; https://doaj.org/toc/2666-1683 |
| DOI: | 10.1016/j.euros.2023.10.005 |
| Access URL: | https://doaj.org/article/99d52e6544e34e3aa02f8551dfda4e1a |
| Accession Number: | edsdoj.99d52e6544e34e3aa02f8551dfda4e1a |
| Database: | Directory of Open Access Journals |
| ISSN: | 26661683 |
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| DOI: | 10.1016/j.euros.2023.10.005 |
| Published in: | European Urology Open Science |
| Language: | English |