Targeting of tracked tumor foci ups gleason score upgrading
Nima Nassiri, M.D., from the University of California in Los Angeles, and colleagues examined the rate of upgrading to Gleason score 4 + 3 or greater in 259 prostate cancer patients who were diagnosed via magnetic resonance imaging (MRI)/ultrasound fusion guided biopsy from 2009 to 2015 and underwent fusion biopsy during active surveillance.
The researchers found that men with Gleason score 3 + 4 were 4.65 times more likely to have upgrading at three years than men with Gleason score of 3 + 3 (P < 0.01). By the third surveillance year, 63 and 18.0 percent of men with Gleason score 3 + 4 and 3 + 3, respectively, had been upgraded (P < 0.01). Ninety-seven percent of the 33 upgrades occurred at a MRI-visible or a tracked site of tumor, instead of a previously negative systematic site. Gleason score 3 + 4, prostate-specific antigen density 0.15 ng/ml/cm³ or greater, and a grade 5 lesion on MRI were independent predictors of upgrading.
"During active surveillance of prostate cancer, targeting of tracked tumor foci by MRI/ultrasound fusion biopsy allows for heightened detection of Gleason score 4 + 3 or greater cancers," the authors write.
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