MP09-02 THE SIGNIFICANCE OF ANTERIOR PROSTATE LESIONS ON MULTIPARAMETRIC MRI IN AFRICAN AMERICAN MEN (2016)

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History II1 Apr 2016MP09-02 THE SIGNIFICANCE OF ANTERIOR PROSTATE LESIONS ON MULTIPARAMETRIC MRI IN AFRICAN AMERICAN MEN Michael Kongnyuy, Abhinav Sidana, Arvin George, Akhil Muthigi, Meet Kadakia, Amogh Iyer, Thomas Frye, Michele Fascelli, Richard Ho, Francesca Mertan, Minhaj Siddiqui, Daniel Su, Maria Merino, Baris Turkbey, Peter Choyke, Bradford Wood, and Peter Pintoi Michael KongnyuyMichael Kongnyuy More articles by this author , Abhinav SidanaAbhinav Sidana More articles by this author , Arvin GeorgeArvin George More articles by this author , Akhil MuthigiAkhil Muthigi More articles by this author , Meet KadakiaMeet Kadakia More articles by this author , Amogh IyerAmogh Iyer More articles by this author , Thomas FryeThomas Frye More articles by this author , Michele FascelliMichele Fascelli More articles by this author , Richard HoRichard Ho More articles by this author , Francesca MertanFrancesca Mertan More articles by this author , Minhaj SiddiquiMinhaj Siddiqui More articles by this author , Daniel SuDaniel Su More articles by this author , Maria MerinoMaria Merino More articles by this author , Baris TurkbeyBaris Turkbey More articles by this author , Peter ChoykePeter Choyke More articles by this author , Bradford WoodBradford Wood More articles by this author , and Peter PintoiPeter Pintoi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2289AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES African American (AA) men tend to harbor higher-risk prostate cancer (PCa) and exhibit inferior outcomes when compared to other groups. It has been postulated that AA men may harbor more anterior prostate lesions (APLs) that are undersampled by standard transrectal ultrasound guided biopsy (SBx), potentially resulting in greater degree of Gleason score (GS) upgrading at radical prostatectomy (RP). We aimed to evaluate the significance of APLs in AA men on multiparametric MRI (mpMRI) and compare with a matched cohort of White/Other men. METHODS A review of 1260 men who had an mpMRI with suspicious prostate lesions and underwent MR-TRUS fusion guided biosy (FBx) with concurrent SBx in the same biopsy session was performed. All AA men were matched to a control group of W/O men using a 1:1 propensity score-matching algorithm with age, prostate specific antigen (PSA) and prostate volume as matching variables. Logistic regression analysis was used to determine predictors of APLs in AA men. Whole mount histopathologic correlation was performed for men undergoing RP. RESULTS Of 195 AA men, 93 (47.7%) had a total of 109 APLs. Prior negative SBx was associated with the presence of APLs in AA men (OR: 1.81, 95% CI: 1.03-3.20, p=0.04). On multivariate logistic regression analysis, a smaller prostate (p=0.001) and rising PSA (p=0.007) were independent predictors of the presence of PCa in APLs in AA men. Comparative analysis of AA (93/195, 47.7%) versus W/O (100/194, 52%) showed no difference in the rate of APLs (p=0.44) or GS distribution (p=0.63) despite an overall higher cancer detection rate in AA men, p=0.007. In cases where APLs were positive for PCa on FBx, the GS of APL was equal to the highest GS of the entire gland in 82.9% (29/35) of AA and 90.9% (30/33) of W/O. APL GS was in concordance with whole mount pathology at RP 77% (10/13) and 53% (8/15) of the time in AA and W/O men, respectively (Table 1). CONCLUSIONS Cancer positive APLs represented the highest-risk GS in the majority of cases, and also correlated with final pathology in AA men. In our matched cohort, AA men were equally likely to have an APL on mpMRI as a patient from White/Other race. Targeting of APLs via FBx can clinically improve PCa risk stratification and guide appropriate treatment options. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e93-e94 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Michael Kongnyuy More articles by this author Abhinav Sidana More articles by this author Arvin George More articles by this author Akhil Muthigi More articles by this author Meet Kadakia More articles by this author Amogh Iyer More articles by this author Thomas Frye More articles by this author Michele Fascelli More articles by this author Richard Ho More articles by this author Francesca Mertan More articles by this author Minhaj Siddiqui More articles by this author Daniel Su More articles by this author Maria Merino More articles by this author Baris Turkbey More articles by this author Peter Choyke More articles by this author Bradford Wood More articles by this author Peter Pintoi More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...