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Impact of MRI and targeted biopsies on eligibility and disease reclassification in MRI-positive candidates for active surveillance on systematic biopsies

Urology Jan 08, 2020

Ploussard G, Beauval JB, Lesourd M, et al. - From a prospective database, experts involved all pre-biopsy MRI-positive males fulfilling active surveillance (AS) measures at diagnosis (Toronto (n = 114), UCSF (n = 82), or PRIAS (n = 60) criteria) on systematic biopsies (SB) in order to evaluate the effect of concomitant targeted biopsies (TB) for prognosticating final disease reclassification in MRI-positive low-risk prostate cancer individuals suitable for AS on SB. All people who undergo a combination of SB and software-based fusion TB, and an immediate radical prostatectomy. Findings suggest that in MRI-positive people, the risk of disease reclassification was relative whatever the SB-based AS criteria utilized. TB was predictive of final upgrading, with a different impact according to the AS criteria. SB characteristics remained appropriate for reclassification prediction even in case of positive TB. Moreover, the risk of upstaged disease remains significant, nearly one third, and neither targeted/systematic biopsy parameters nor MRI findings could perfectly prognosticate it.
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