Mp38-05 outcomes of grade group 2 and 3 prostate cancer on initial versus confirmatory biopsy: implications for active surveillance

You have accessJournal of UrologyCME1 Apr 2023MP38-05 OUTCOMES OF GRADE GROUP 2 AND 3 PROSTATE CANCER ON INITIAL VERSUS CONFIRMATORY BIOPSY: IMPLICATIONS FOR ACTIVE SURVEILLANCE Marlon Perera, Ghalib Jibara, Amy Tin, Daniel Sjoberg, Nicole Benfante, Sigrid Carlsson, James Eastham, Vincent Laudone, Samson Fine, Peter Scardino, Andrew Vickers, and Behfar Ehdaie Marlon PereraMarlon Perera More articles by this author , Ghalib JibaraGhalib Jibara More articles by this author , Amy TinAmy Tin More articles by this author , Daniel SjobergDaniel Sjoberg More articles by this author , Nicole BenfanteNicole Benfante More articles by this author , Sigrid CarlssonSigrid Carlsson More articles by this author , James EasthamJames Eastham More articles by this author , Vincent LaudoneVincent Laudone More articles by this author , Samson FineSamson Fine More articles by this author , Peter ScardinoPeter Scardino More articles by this author , Andrew VickersAndrew Vickers More articles by this author , and Behfar EhdaieBehfar Ehdaie More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003276.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We aimed to compare outcomes among men with GG2/3 prostate cancer on initial biopsy with outcomes among men whose disease was initially GG1 but was upgraded to GG2/3 on confirmatory biopsy. METHODS: We reviewed patients undergoing radical prostatectomy (RP) in 2 cohorts: “immediate RP group,” with GG2/3 cancer on diagnostic biopsy, and “AS group,” with GG1 cancer on initial biopsy that was upgraded to GG2/3 on confirmatory biopsy. Probabilities of biochemical recurrence (BCR) and salvage therapy using multivariable Cox regression models with risk adjustment. Risk of adverse pathology at RP were also compared using logistic regression. RESULTS: The immediate RP group comprised 4009 patients; the AS group comprised 321. The AS group had lower adjusted rates of adverse pathology (27% vs 35%, p=0.003). BCR rates were lower in the AS group, though this did not reach conventional significance (HR 0.73; 95%CI 0.50-1.06; p=0.10) compared with the immediate RP group. Risk-adjusted 1- and 5-year BCR rates were 4.6% (95%CI 3.0-6.5%) and 10.4% (95%CI 6.9-14%), respectively, for the AS group compared with 6.3% (95%CI 5.6-7.0%) and 20% (95%CI 19-22%) in the immediate RP group. A non-significant association was observed for salvage treatment–free survival favoring the AS group (HR 0.67, 95%CI 0.42, 1.06, p=0.087). CONCLUSIONS: We found that men with low-risk cancer who were upgraded on confirmatory biopsy tend to have less aggressive disease than men with the same grade found at initial biopsy. These results must be confirmed in larger series before recommendations can be made regarding a more conservative approach in men with upgraded pathology on surveillance biopsy. Source of Funding: This work was supported by the Sidney Kimmel Center for Prostate and Urologic Cancers at MSK, NIH/NCI grant P50 CA092629, and the NIH/NCI Cancer Center Support Grant to Memorial Sloan Kettering Cancer Center (P30 CA008748). Marlon Perera is sponsored by the Australian-America Fulbright Commission administered through a 2021–2022 Fulbright Future Scholarship funded by The Kinghorn Foundation. Sigrid Carlsson is supported by NIH/NCI grant K22 CA234400 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e525 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marlon Perera More articles by this author Ghalib Jibara More articles by this author Amy Tin More articles by this author Daniel Sjoberg More articles by this author Nicole Benfante More articles by this author Sigrid Carlsson More articles by this author James Eastham More articles by this author Vincent Laudone More articles by this author Samson Fine More articles by this author Peter Scardino More articles by this author Andrew Vickers More articles by this author Behfar Ehdaie More articles by this author Expand All Advertisement PDF downloadLoading ...