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Kornienko, Kira; Siegel, Fabian; Borkowetz, Angelika; Hoffmann, Manuela A.; Drerup, Martin; Lieb, Verena; Bruendl, Johannes; Höfner, Thomas; Cash, Hannes; von Hardenberg, Jost; Westhoff, Niklas; von Hardenberg, Jost; Beyer, Burkhard; Bründl, Johannes; Cash, Johannes; Herrmann, Jonas; Radtke, Jan Philipp; Hoffmann, Manuela A.; Leitsmann, Conrad; Kornienko, Kira; Worst, Thomas; Borgmann, Hendrik; Linxweiler, Johannes; Klümper, Niklas; [...]

Active surveillance inclusion criteria under scrutiny in magnetic resonance imaging-guided prostate biopsy: a multicenter cohort study

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  • Media type: E-Article
  • Title: Active surveillance inclusion criteria under scrutiny in magnetic resonance imaging-guided prostate biopsy: a multicenter cohort study
  • Contributor: Kornienko, Kira; Siegel, Fabian; Borkowetz, Angelika; Hoffmann, Manuela A.; Drerup, Martin; Lieb, Verena; Bruendl, Johannes; Höfner, Thomas; Cash, Hannes; von Hardenberg, Jost; Westhoff, Niklas; von Hardenberg, Jost; Beyer, Burkhard; Bründl, Johannes; Cash, Johannes; Herrmann, Jonas; Radtke, Jan Philipp; Hoffmann, Manuela A.; Leitsmann, Conrad; Kornienko, Kira; Worst, Thomas; Borgmann, Hendrik; Linxweiler, Johannes; Klümper, Niklas; [...]
  • imprint: Springer Science and Business Media LLC, 2022
  • Published in: Prostate Cancer and Prostatic Diseases
  • Language: English
  • DOI: 10.1038/s41391-021-00478-2
  • ISSN: 1365-7852; 1476-5608
  • Keywords: Cancer Research ; Urology ; Oncology
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Although multiparametric magnetic resonance imaging (mpMRI) is recommended for primary risk stratification and follow-up in Active Surveillance (AS), it is not part of common AS inclusion criteria. The objective was to compare AS eligibility by systematic biopsy (SB) and combined MRI-targeted (MRI-TB) and SB within real-world data using current AS guidelines.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>A retrospective multicenter study was conducted by a German prostate cancer (PCa) working group representing six tertiary referral centers and one outpatient practice. Men with PCa and at least one MRI-visible lesion according to Prostate Imaging Reporting and Data System (PI-RADS) v2 were included. Twenty different AS inclusion criteria of international guidelines were applied to calculate AS eligibility using either a SB or a combined MRI-TB and SB. Reasons for AS exclusion were assessed.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Of 1941 patients with PCa, per guideline, 583–1112 patients with PCa in both MRI-TB and SB were available for analysis. Using SB, a median of 22.1% (range 6.4–72.4%) were eligible for AS. Using the combined approach, a median of 15% (range 1.7–68.3%) were eligible for AS. Addition of MRI-TB led to a 32.1% reduction of suitable patients. Besides Gleason Score upgrading, the maximum number of positive cores were the most frequent exclusion criterion. Variability in MRI and biopsy protocols potentially limit the results.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Only a moderate number of patients with PCa can be monitored by AS to defer active treatment using current guidelines for inclusion in a real-world setting. By an additional MRI-TB, this number is markedly reduced. These results underline the need for a contemporary adjustment of AS inclusion criteria.</jats:p> </jats:sec>