To investigate outcomes and undetected clinically significant prostate cancer (csPCa) in patients with negative mpMRI and clinical suspicion for prostate cancer, where csPCa is defined as ISUP ≥ 2.
Key Findings:
20.7% of patients who underwent biopsy post-negative mpMRI were diagnosed with prostate carcinoma, indicating a notable risk.
Only 6.7% of these cases were classified as clinically significant prostate cancer (ISUP ≥ 2), suggesting a low rate of significant findings.
Older age at initial mpMRI was an independent predictor for undergoing biopsy after negative mpMRI.
Interpretation:
The study highlights the need for careful consideration before proceeding with biopsies in patients with negative mpMRI, as a significant proportion may not have clinically significant cancer, potentially impacting treatment decisions.
Limitations:
The study is retrospective and may have selection bias, which could skew the results.
Variability in MRI protocols and biopsy techniques may affect generalizability of the findings.
Limited follow-up duration may not capture long-term outcomes, necessitating further studies.
Conclusion:
Further investigation is warranted to refine decision-making regarding biopsies in patients with negative mpMRI and clinical suspicion for prostate cancer, particularly focusing on the role of additional prognostic factors.
by Maximilian Haack, Vanessa Miksch, Zhe Tian, Gregor Duwe, Anita Thomas, Angelika Borkowetz, Kristina Stroh, Christian Thomas, Axel Haferkamp, Thomas Höfner, Katharina Boehm
