Suitability of conventional systematic vs. MRI-guided targeted biopsy approaches to assess surgical treatment delay for radical prostatectomy
- 11.11.2022
- Original Article
Erschienen in:
- Verfasst von
- Mykyta Kachanov
- Lars Budäus
- Jorn H. Witt
- Christian Wagner
- Joerg Zinke
- Bernhard Fangmeyer
- Andreas Schütte
- Tilmann Spieker
- Dirk Beyersdorff
- Markus Graefen
- Pawel Rachubinski
- Sami-Ramzi Leyh-Bannurah
- Erschienen in
- World Journal of Urology | Ausgabe 12/2022
Abstract
Objectives
To assess if systematic (SBx) vs. transrectal or transperineal mpMRI-ultrasound targeted combined with systematic (TBx + SBx) biopsy confer different effects on treatment delay to radical prostatectomy measured as Gleason grade group (GGG) upgrade of prostate cancer (PCa).
Materials and methods
We relied on a multi-institutional cohort of localized PCa patients who underwent RP in Martini-Klinik, Hamburg, or Prostate Center Northwest, Gronau, between 2014 and 2022. Analyses were restricted to PCa GGG 1–3 diagnosed at SBx (n = 4475) or TBx + SBx (n = 1282). Multivariable logistic regression modeling (MVA) predicting RP GGG upgrade of ≥ 1 was performed separately for SBx and TBx + SBx.
Results
Treatment delay to RP of < 90, 90–180 and 180–365 days was reported in 59%, 35% and 6.2% of SBx and in 60%, 34% and 5.9% of the TBx + SBx patients, respectively. Upgrade to GGG ≥ 4 at RP was detected in 15% of SBx patients and 0.86% of TBx patients. In MVA performed for SBx, treatment delay yielded independent predictor status (OR 1.17 95% CI 1.02–1.39, p = 0.028), whereas for TBx + SBx MVA, statistical significance was not achieved.
Conclusion
Treatment delay remained independently associated with radical prostatectomy GGG upgrade after adjustment for clinical variables in the patients diagnosed with SBx alone, but not in those who received combined TBx + SBx. These findings can be explained through inherent misclassification rates of SBx, potentially obfuscating historical observations of natural PCa progression and potential dangers of treatment delay. Thus, mpMRI-guided combined TBx + SBx appears mandatory for prospective delay-based examinations of PCa.
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- Titel
- Suitability of conventional systematic vs. MRI-guided targeted biopsy approaches to assess surgical treatment delay for radical prostatectomy
- Verfasst von
-
Mykyta Kachanov
Lars Budäus
Jorn H. Witt
Christian Wagner
Joerg Zinke
Bernhard Fangmeyer
Andreas Schütte
Tilmann Spieker
Dirk Beyersdorff
Markus Graefen
Pawel Rachubinski
Sami-Ramzi Leyh-Bannurah
- Publikationsdatum
- 11.11.2022
- Verlag
- Springer Berlin Heidelberg
- Erschienen in
-
World Journal of Urology / Ausgabe 12/2022
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726 - DOI
- https://doi.org/10.1007/s00345-022-04207-9
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