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  11. Association Of Extended Core Sampling With Delayed Intervention And Pathologic Outcomes For Active Surveillance Patients A Population-based Analysis

Association of extended core sampling with delayed intervention and pathologic outcomes for active surveillance patients A population-based analysis

Rashid K Sayyid1, Rui Bernardino1, Zizo Al-Daqqaq2

  • 1Division of Urology, Department of Surgical Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, ON, Canada.

Canadian Urological Association Journal = Journal De L'Association Des Urologues Du Canada
|February 6, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Extended prostate cancer biopsy sampling reduces the likelihood of discontinuing active surveillance and experiencing pathologic upgrading. This approach improves risk stratification for patients on active surveillance.

Area of Science:

  • Urology
  • Oncology
  • Pathology

Background:

  • Combined systematic and targeted biopsy improves clinically significant prostate cancer detection.
  • Active surveillance (AS) is a management strategy for low-risk prostate cancer.
  • Optimizing initial biopsy strategies is crucial for effective AS management.

Purpose of the Study:

  • To evaluate if extended core sampling at initial biopsy impacts AS discontinuation.
  • To assess the association between extended core sampling and subsequent pathologic outcomes in AS patients.
  • To determine the optimal biopsy strategy for risk-stratifying patients eligible for active surveillance.

Main Methods:

  • Analysis of National Comprehensive Cancer Network (NCCN) low- and favorable-intermediate-risk (FIR) AS patients (2010-2015) from SEER database.

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  • Biopsy sampling categorized as standard (10-12 cores), extended (13-20 cores), or super-extended (21+ cores).
  • Multivariable logistic regression used to analyze outcomes including delayed definitive intervention and pathologic upgrading/downgrading.

    • Main Results:

    • Extended core sampling decreased definitive intervention odds in low-risk and GG2 FIR patients.
    • Super-extended sampling decreased definitive intervention odds in PSA 10-20 FIR patients.
    • Super-extended sampling reduced odds of upgrading to ≥GG2 in low-risk and ≥GG3 in GG2 FIR patients.

    Conclusions:

    • Extended and super-extended biopsy sampling are linked to lower AS discontinuation rates.
    • Increased core sampling at diagnosis improves pathologic risk stratification for AS patients.
    • Extended tissue sampling is vital for minimizing AS discontinuation and ensuring accurate patient management.