Does the type of biopsy used for diagnosis impact subsequent treatment selection in prostate cancer patients?

Multiparametric magnetic resonance imaging (mpMRI) targeted biopsy has emerged as an augmentation to systematic prostate biopsy (SBx) with improved diagnostic accuracy. The purpose of this study was to determine whether biopsy modality impacted management of prostate cancer (PCa). We performed a ret...

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Bibliographic Details
Published in:The aging male 2022-12, Vol.25 (1), p.23-28
Main Authors: Levin, Brandon A., Lama, Daniel J., Sussman, Jonathan, Guan, Tianyuan, Rao, Marepalli, Tobler, Juliana, Verma, Sadhna, Sidana, Abhinav
Format: Article
Language:English
Subjects:
Aging
Biopsy
Cancer surgery
cancer treatment
Humans
Image-Guided Biopsy
Magnetic Resonance Imaging
Male
Medical diagnosis
Mens health
MRI
Older people
Prostate
Prostate cancer
Prostatectomy
Prostatic Neoplasms - surgery
Retrospective Studies
Urological surgery
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Summary:Multiparametric magnetic resonance imaging (mpMRI) targeted biopsy has emerged as an augmentation to systematic prostate biopsy (SBx) with improved diagnostic accuracy. The purpose of this study was to determine whether biopsy modality impacted management of prostate cancer (PCa). We performed a retrospective review of patients with newly diagnosed non-metastatic PCa at our institution (2014-2020). Either ultrasound-guided 12-core SBx or SBx plus ≥1targeted biopsy cores from identifiable lesions on mpMRI were performed. Patients were managed with active surveillance (AS), radiation therapy (RT), or radical prostatectomy (RP). Multivariate logistic and multinomial regression analyses were performed. Of 578 patients, 221(38%) proceeded with AS, 121(21%) received RT, and 236(41%) underwent RP. Median age and prostate-specific antigen (PSA) were 65.4 years and 7.2 ng/mL, respectively. On multivariate analysis, biopsy type did not predict decision to pursue treatment (p=.951). On multinomial regression analysis, biopsy type did not predict selection of AS over RP (p=.973) or RT over RP (p=.813). Alternatively, age, grade group, and PSA were significant predictors of management selection. Biopsy technique did not impact management for patients with new PCa diagnosis. Despite paradigm shifts in obtaining tissue diagnosis, age, PSA, and grade group remain valuable indices for shared decision-making and counseling patients with PCa.
ISSN:1368-5538
1473-0790
DOI:10.1080/13685538.2021.2023125