The Impact of Mpmri-Targeted Vs Systematic Biopsy on the Risk of Prostate Cancer Downgrading at Final Pathology

Although targeted biopsies (TBx) are associated with improved disease assessment, concerns have been raised regarding the risk of prostate cancer (PCa) overgrading due to more accurate biopsy core deployment in the index lesion. We identified 1672 patients treated with radical prostatectomy (RP) with a positive mpMRI and ISUP ≥ 2 PCa detected via systematic biopsy (SBx) plus TBx. We compared downgrading rates at RP (ISUP 4–5, 3, and 2 at biopsy, to a lower ISUP) for PCa detected via SBx only (group 1), via TBx only (group 2), and eventually for PCa detected with the same ISUP 2–5 at both SBx and TBx (group 3), using multivariable logistic regression models (MVA). Overall, 12 vs 14 vs 6