TY  - JOUR
A1  - Wenzel, Mike
A1  - Würnschimmel, Christoph
A1  - Chierigo, Francesco
A1  - Tian, Zhe
A1  - Shariat, Shahrokh F.
A1  - Terrone, Carlo
A1  - Saad, Fred
A1  - Tilki, Derya
A1  - Graefen, Markus
A1  - Roos, Frederik
A1  - Kluth, Luis
A1  - Mandel, Philipp
A1  - Felix, Chun
A1  - Karakiewicz, Pierre I.
T1  - Assessment of the optimal number of positive biopsy cores to discriminate between cancer-specific mortality in high-risk versus very high-risk prostate cancer patients
T2  - The prostate
N2  - Background: Number of positive prostate biopsy cores represents a key determinant between high versus very high-risk prostate cancer (PCa). We performed a critical appraisal of the association between the number of positive prostate biopsy cores and CSM in high versus very high-risk PCa. Methods: Within Surveillance, Epidemiology, and End Results database (2010–2016), 13,836 high versus 20,359 very high-risk PCa patients were identified. Discrimination according to 11 different positive prostate biopsy core cut-offs (≥2–≥12) were tested in Kaplan–Meier, cumulative incidence, and multivariable Cox and competing risks regression models. Results: Among 11 tested positive prostate biopsy core cut-offs, more than or equal to 8 (high-risk vs. very high-risk: n = 18,986 vs. n = 15,209, median prostate-specific antigen [PSA]: 10.6 vs. 16.8 ng/ml, <.001) yielded optimal discrimination and was closely followed by the established more than or equal to 5 cut-off (high-risk vs. very high-risk: n = 13,836 vs. n = 20,359, median PSA: 16.5 vs. 11.1 ng/ml, p < .001). Stratification according to more than or equal to 8 positive prostate biopsy cores resulted in CSM rates of 4.1 versus 14.2% (delta: 10.1%, multivariable hazard ratio: 2.2, p < .001) and stratification according to more than or equal to 5 positive prostate biopsy cores with CSM rates of 3.7 versus 11.9% (delta: 8.2%, multivariable hazard ratio: 2.0, p < .001) in respectively high versus very high-risk PCa. Conclusions: The more than or equal to 8 positive prostate biopsy cores cutoff yielded optimal results. It was very closely followed by more than or equal to 5 positive prostate biopsy cores. In consequence, virtually the same endorsement may be made for either cutoff. However, more than or equal to 5 positive prostate biopsy cores cutoff, based on its existing wide implementation, might represent the optimal choice.
KW  - biopsy cores
KW  - high risk
KW  - NCCN
KW  - prostate cancer
KW  - very high risk
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/63937
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-639377
SN  - 1097-0045
VL  - 81
IS  - 14
SP  - 1055
EP  - 1063
PB  - Wiley-Liss
CY  - New York, NY
ER  -