A total of 404 patients who underwent mpMRI of the prostate were analyzed in this study. All patients underwent targeted and systematic biopsies at two tertiary referral centers between 2013 and 2018. The patients included in the study were either biopsy-naïve or with a previous negative biopsy. All patients had a negative digital rectal examination and a single suspicious mpMRI lesion. All suspicious mpMRI lesions were targeted with up to 4 cores per lesion. The main outcome of the study was clinically significant prostate cancer (Gleason >=3+4) at the targeted biopsy. The authors also performed multivariable logistic regression models to predict clinically significant prostate cancer in PIRADS 3,4, and 5 separately. Covariates in the models included age, PSA density, volume of the suspicious lesion, and number of target cores.
Table 1 demonstrated the basic characteristics of the patients. The multivariable models demonstrated that the number of target cores was not associated with a clinically significant prostate cancer diagnosis in the target biopsy in PIRADS 3,4 and 5 (Tables 2 and 3).
The authors concluded that the number of targeted cores is not a significant predictor of clinically significant prostate cancer diagnosed in the targeted biopsy, across all relevant PIRADS scores. The authors question whether one single core should be sufficient in accurately sampling a suspicious mpMRI lesion. More data is required to answer this important question.
Table 1 – Patient characteristics:
Table 2 – Multivariable models predicting clinically significant prostate cancer for PIRADS 3, and 4 lesions:
Table 3 – Multivariable models predicting clinically significant prostate cancer for PIRADS 5 lesions:
Presented by: Paolo Dell'Oglio, Scientific Institute for Research and Healthcare, IRCCS Ospedale San Raffaele, Division of Oncology, Unit of Urology, Milan, Italy
Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre @GoldbergHanan at the 34th European Association of Urology (EAU 2019) #EAU19 conference in Barcelona Spain, March 15-19, 2019.