Pd57-06 factors predicting clinically significant prostate cancer in pirads 3 lesions

You have accessJournal of UrologyCME1 May 2022PD57-06 FACTORS PREDICTING CLINICALLY SIGNIFICANT PROSTATE CANCER IN PIRADS 3 LESIONS Jasmine Lin, Mohammad Rashid Siddiqui, Eric Li, Jonathan Aguiar, Brandon Ansbro, Moataz Soliman, Jordan Rich, Johan Alfaro, Mary Kate Keeter, Edward Schaeffer, and Ashley Ross Jasmine LinJasmine Lin More articles by this author , Mohammad Rashid SiddiquiMohammad Rashid Siddiqui More articles by this author , Eric LiEric Li More articles by this author , Jonathan AguiarJonathan Aguiar More articles by this author , Brandon AnsbroBrandon Ansbro More articles by this author , Moataz SolimanMoataz Soliman More articles by this author , Jordan RichJordan Rich More articles by this author , Johan AlfaroJohan Alfaro More articles by this author , Mary Kate KeeterMary Kate Keeter More articles by this author , Edward SchaefferEdward Schaeffer More articles by this author , and Ashley RossAshley Ross More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002637.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Though PIRADS 3 lesions are commonly biopsied, the majority are benign. Here, we sought to investigate factors that may help better risk stratify the PIRADS-3 lesions and predict the presence of clinically significant cancer (defined as Gleason Grade Group (GG) ≥ 2). METHODS: We queried the electronic medical record for patients diagnosed with PIRADS 3 lesions beginning in March 2018 with the focus on patients with total PSA 2-20ng/mL. We compared the clinical characteristics such as Age, African American race, PSA, prostate health index (PHI), and PSA Density (PSAD) of patients with and without clinically significant prostate cancer on biopsy (Table 1). Statistics were performed using t-test, chi-squared analysis, and logistical regressions with significance defined as p<0.05. RESULTS: From March 2018 to present, 3553 men presented to urology at Northwestern Memorial Hospital with suspicion of prostate cancer with 1640 (46%) undergoing prostate MRI. 362 (22%) of men were identified to have the PIRADS 3 lesion as their highest PIRADS lesion. Subsequently, 280 (77%) men underwent prostate needle biopsy with clinically significant cancer detected in 57 (20%) of patients (171 (61%) were negative, while GG1 was found in 51 (18%) of patients). A significant difference was noted between the two groups for PHI (p-value 0.0001) and PSAD (p-value 0.001). Significant predictors of finding clinically significant prostate cancer on biopsy on multivariable analysis included PSAD >0.15 (OR 3.7, 95% CI 0.86-11.60) and PHI ≥ 55(OR 7.5, 95% CI 1.3-41.5). CONCLUSIONS: Consistent with literature, majority of PIRADS 3 lesions are benign in our series, but these lesions can be further risk stratified based on serum biomarker of PHI and PSAD. Roughly 90% of biopsies for men with PIRADS 3 lesions and PHI <36 or PSAD <0.15 failed to demonstrate clinically significant prostate cancer and consideration for biopsy avoidance should be made in these men. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e962 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jasmine Lin More articles by this author Mohammad Rashid Siddiqui More articles by this author Eric Li More articles by this author Jonathan Aguiar More articles by this author Brandon Ansbro More articles by this author Moataz Soliman More articles by this author Jordan Rich More articles by this author Johan Alfaro More articles by this author Mary Kate Keeter More articles by this author Edward Schaeffer More articles by this author Ashley Ross More articles by this author Expand All Advertisement PDF downloadLoading ...