Boston—Findings from a retrospective analysis of data collected at the National Institutes of Health (NIH) provide insight on how multiparametric MRI/transrectal ultrasound-fusion biopsy (“fusion biopsy”) may be affecting management patterns and outcomes for men with prostate cancer.
The study identified 1,260 men who underwent a first fusion biopsy followed by systematic biopsy at the NIH.
Prostate cancer was detected in 721 men (57.2%). Among 465 men with localized disease who had data available on chosen treatment and outcomes, 206 (44.3%) enrolled on active surveillance, 204 (43.9%) underwent radical prostatectomy, and 55 (11.8%) received radiation therapy.
Comparisons between the treatment groups showed men who received radiation were significantly older and had a significantly higher PSA level than their counterparts electing for active surveillance or who had radical prostatectomy. The study also found that men whose Gleason score was upgraded based on fusion biopsy compared with the systematic biopsy were significantly more likely to choose definitive therapy over active surveillance than men whose results were the same with the two techniques or who had a higher grade on systematic versus fusion biopsy.
In addition, “compared with historical cohorts from the CaPSURE and SEER studies in which prostate cancer was diagnosed by systematic biopsy, the percentage of men choosing active surveillance was higher in the fusion biopsy cohort,” said Joseph A. Baiocco, medical research scholar at the NIH’s Urologic Oncology Branch, Bethesda, MD, and a medical student at Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia.
“One possible explanation for this difference is that physicians are more confident that the fusion biopsy gives an accurate assessment of disease burden. Consequently, based on its findings, physicians and patients are more comfortable choosing active surveillance,” he told Urology Times. Baiocco worked on the study with Peter A. Pinto, MD, and colleagues.
Next: Further study needed