MP47-10 MRI USE ALTERS PROSTATE CANCER MANAGEMENT PATTERNS: TREATMENT TRENDS IN THE IMAGE-GUIDED BIOPSY ERA. (2017)

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy IV1 Apr 2017MP47-10 MRI USE ALTERS PROSTATE CANCER MANAGEMENT PATTERNS: TREATMENT TRENDS IN THE IMAGE-GUIDED BIOPSY ERA. Joseph A. Baiocco, Abhinav Sidana, Raju Chelluri, Kendrick Yim, Arvin K. George, Vladimir Valera, Michael Kongnyuy, Akhil Muthigi, Matthew J. Watson, Mahir Maruf, Maria J. Merino, Baris Turkbey, Peter L. Choyke, Bradford J. Wood, and Peter A. Pinto Joseph A. BaioccoJoseph A. Baiocco More articles by this author , Abhinav SidanaAbhinav Sidana More articles by this author , Raju ChelluriRaju Chelluri More articles by this author , Kendrick YimKendrick Yim More articles by this author , Arvin K. GeorgeArvin K. George More articles by this author , Vladimir ValeraVladimir Valera More articles by this author , Michael KongnyuyMichael Kongnyuy More articles by this author , Akhil MuthigiAkhil Muthigi More articles by this author , Matthew J. WatsonMatthew J. Watson More articles by this author , Mahir MarufMahir Maruf More articles by this author , Maria J. MerinoMaria J. Merino More articles by this author , Baris TurkbeyBaris Turkbey More articles by this author , Peter L. ChoykePeter L. Choyke More articles by this author , Bradford J. WoodBradford J. Wood More articles by this author , and Peter A. PintoPeter A. Pinto More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1470AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES As the use of MRI to diagnose prostate cancer (PCa) becomes established, knowledge of its effect on treatment patterns is needed to better counsel patients. We describe the distribution of PCa treatment modalities in the MRI/TRUS-fusion biopsy (FBx) era at our center to investigate the role of FBx in modulating PCa management patterns. METHODS A retrospective review was performed on a prospectively maintained database of all men who underwent MRI/TRUS FBx at the National Institutes of Health from 2007 to present. Patient demographics, clinical data, imaging, pathology, treatment and outcomes were recorded. Patients were stratified by treatment into active surveillance (AS), radical prostatectomy (RP), radiation therapy (RT) +/- androgen deprivation therapy, or other therapy (including experimental treatments, focal laser ablation (FLA) or medical therapy). Groups were compared using t-test, Fischer exact test, and ANOVA (Graphpad prism software). Progression free survival was estimated using Kaplan-Meier curves (SPSS software). RESULTS 1260 men were reviewed (mean age 62.4 years; mean PSA 9.8 ng/dL). The overall PCa detection rate was 57.2% (n = 721). 517 men had available treatment data and either entered AS (38.9%, n=201), received RP (40.2%, n=208), RT +/- ADT (10.6, n=55), medical treatment (7.9%, n=41), or FLA (2.32%, n=12). The age, PSA, Gleason Scores (GI), and imaging characteristics are described for each of these groups in Table 1. Younger patients were more likely to choose RP over AS or RT (p<0.0001). The median PSA for those who received RT was higher than those on AS or who received RP (p<0.0001). The mean estimated progression free survival for AS was 105 months. The mean estimated BCR free survival was 71 months and 96 months for RP and RT, respectively (p=0.02). FBx upgrade (FBx GI > standard biopsy (SBx) GI) was significantly more common in patients who received either RP or RT when compared to SBx upgrade (p<0.0001). CONCLUSIONS MRI/TRUS-FBx use in the diagnosis of PCa results in more accurate assessment of disease burden and modulates treatment modality chosen by patients. FBx upgrade occurred in an increased proportion of patients choosing either RP or RT over AS. Further study is required to delineate the use and benefits of FBx when counseling patients on management options. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e631-e632 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Joseph A. Baiocco More articles by this author Abhinav Sidana More articles by this author Raju Chelluri More articles by this author Kendrick Yim More articles by this author Arvin K. George More articles by this author Vladimir Valera More articles by this author Michael Kongnyuy More articles by this author Akhil Muthigi More articles by this author Matthew J. Watson More articles by this author Mahir Maruf More articles by this author Maria J. Merino More articles by this author Baris Turkbey More articles by this author Peter L. Choyke More articles by this author Bradford J. Wood More articles by this author Peter A. Pinto More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...