Impact of the MyProstateScore (MPS) Test on the Clinical Decision to Undergo Prostate Biopsy: Results From a Contemporary Academic Practice.

Autor: Lebastchi AH; Department of Urology, University of Michigan, Ann Arbor, MI. Electronic address: amir.lebastchi@gmail.com., Russell CM; Department of Urology, University of Michigan, Ann Arbor, MI., Niknafs YS; Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI., Eyrich NW; Department of Urology, University of Michigan, Ann Arbor, MI., Chopra Z; Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI., Botbyl R; Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI., Kabeer R; Department of Urology, University of Michigan, Ann Arbor, MI., Osawa T; Department of Urology, University of Michigan, Ann Arbor, MI., Siddiqui J; Department of Urology, University of Michigan, Ann Arbor, MI; Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI., Siddiqui R; Department of Urology, University of Michigan, Ann Arbor, MI., Davenport MS; Department of Radiology and Urology, University of Michigan, Ann Arbor, MI., Mehra R; Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI; Department of Pathology, University of Michigan, Ann Arbor, MI., Tomlins SA; Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI; Department of Pathology, University of Michigan, Ann Arbor, MI., Kunju LP; Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI; Department of Pathology, University of Michigan, Ann Arbor, MI., Chinnaiyan AM; Department of Urology, University of Michigan, Ann Arbor, MI; Rogel Cancer Center, University of Michigan, Ann Arbor, MI; Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI; Department of Pathology, University of Michigan, Ann Arbor, MI; Howard Hughes Medical Institute, University of Michigan, Ann Arbor, MI., Wei JT; Department of Urology, University of Michigan, Ann Arbor, MI; Dow Division of Health Services Research, University of Michigan, Ann Arbor, MI., Tosoian JJ; Department of Urology, University of Michigan, Ann Arbor, MI; Rogel Cancer Center, University of Michigan, Ann Arbor, MI; Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI. Electronic address: jtosoian@med.umich.edu., Morgan TM; Department of Urology, University of Michigan, Ann Arbor, MI; Rogel Cancer Center, University of Michigan, Ann Arbor, MI; Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI.
Jazyk: angličtina
Zdroj: Urology [Urology] 2020 Nov; Vol. 145, pp. 204-210. Date of Electronic Publication: 2020 Aug 08.
DOI: 10.1016/j.urology.2020.07.042
Abstrakt: Objective: To evaluate the association of the MyProstateScore (MPS) urine test on the decision to undergo biopsy in men referred for prostate biopsy in urology practice.
Methods: MPS testing was offered as an alternative to immediate biopsy in men referred to the University of Michigan for prostate biopsy from October 2013 through October 2016. The primary endpoint was the decision to perform biopsy. The proportion of patients undergoing biopsy was compared to predicted risk scores from the Prostate Cancer Prevention Trial risk calculator (PCPTrc). Analyses were stratified by the use of multiparametric magnetic resonance imaging (mpMRI). The associations of PCPTrc, MPS, and mpMRI with the decision to undergo biopsy were explored in a multivariable logistic regression model.
Results: Of 248 patients, 134 (54%) proceeded to prostate biopsy. MPS was significantly higher in biopsied patients (median 29 vs14, P < .001). The use of biopsy was strongly associated with MPS, with biopsy rates of 26%, 38%, 58%, 90%, and 85% in the first through fifth quintiles, respectively (P < .001). MPS association with biopsy persisted upon stratification by mpMRI. On multivariable analysis, MPS was strongly associated with the decision to undergo biopsy when modeled as both a continuous (odds ratio [OR] 1.05, 95%; confidence interval [CI] 1.04-1.08; <.001) and binary (OR 7.76, 95%; CI 4.14-14.5; P < .001) variable.
Conclusion: Many patients (46%) undergoing clinical MPS testing as an alternative to immediate prostate biopsy were able to avoid biopsy. Increasing MPS was strongly associated with biopsy rates. These findings were robust to use of mpMRI.
(Copyright © 2020. Published by Elsevier Inc.)
Databáze: MEDLINE
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