Presentation Authors: Marco Oderda, Giancarlo Marra, Giorgio Calleris, Torino, Italy, Simone Albisinni, Bruxelles, Belgium, Emanuela Altobelli, Roma, Italy, Eduard Baco, Oslo, Norway, Valerio Beatrici, Pesaro-Fano, Italy, Marco Dellabella, Ancona, Italy, Jean-Luc Descotes, Grenoble, France, David Eldred-Evans, London, United Kingdom, Fasolis Giuseppe, Alba, Italy, Mariaconsiglia Ferriero, Roma, Italy, Gaelle Fiard, Grenoble, France, Alessandro Giacobbe, Torino, Italy, Pardeep Kumar, London, United Kingdom, Vito Lacetera, Pesaro-Fano, Italy, Pierre Mozer*, Paris, France, Giovanni Muto, Torino, Italy, Rocco Papalia, Roma, Italy, Alexandre Peltier, Bruxelles, Belgium, Thierry Piechaud, Bordeaux, France, Tiziana Pierangeli, Ancona, Italy, Giuseppe Simone, Roma, Italy, Jean-Baptiste Roche, Bordeaux, France, Morgan Roupret, Paris, France, Paolo Gontero, Torino, Italy
Introduction: In a large multicenter series, we assessed the impact of performing a standard systematic sampling of the prostate in addition to mpMRI-targeted biopsies, in terms of prostate cancer (PCa) and clinically significant (cs) PCa detection.
Methods: We retrospectively enrolled 1.119 patients out of a multicenter retrospective database of 2.115 mpMRI-targeted biopsies. Biopsies were performed using the KoelisTM platform between 2010 and 2017 and consisted in targeted (median 3 cores per target) and systematic (12 to 14 cores) sampling. Overall and csPCa detection rate (CDR) of both target and systematic biopsies represented our primary outcomes. We also investigated potential predictors of PCa detection.
Results: Targeted cores alone detected PCa in about half of the patients undergoing biopsy (48%), while csPCa was diagnosed in one-third (33%). The addition of a systematic sampling improved detection by 15% for all cancers and by 12% for csPCa. Lesion scored as PI-RADS 3, 4 and 5 corresponded to 35%, 69%, and 92% of PCa detection rates, respectively. Higher PI-RADS score and positive digital rectal examination were positively associated with PCa diagnosis, whereas biopsy-naive status was a predictor of csPCa.
Conclusions: Targeted biopsies attain high CDR for both every PCa and csPCa, in daily practice; nevertheless, the addition of a systematic sampling of the gland significantly improves detection rate. Patients with an elevated PI-RADS score and/or a positive DRE had a significantly increased risk to be diagnosed with PCa. Moreover, csPCa detection was associated with a biopsy-naive status.