How do you risk stratify patients with MRI guided prostate biopsies?
This may impact decisions on brachytherapy boost and/or use of ADT since MRI-guided samples may skew patients into the unfavorable risk category
Answer from: Radiation Oncologist at Academic Institution
If the patient has had standard template biopsies and targeted biopsies, I only consider that standard biopsies in the quantification of the proportion of cores involved since the data used to derive the prognostic significance of this feature was based on standard template biopsies not targeted cor...
Answer from: Radiation Oncologist at Community Practice
I'm similar to Dr. @Ennis -- the studies that established the number of cores as risk factors looked at biopsies with 8-10 cores for the most part. In the setting where there are both MRI-guided and standard template biopsies, I divide those out when making decisions on risk stratification involving...
Answer from: Radiation Oncologist at Community Practice
I use the systematic biopsy to determine the core % positivity, I use the highest grade to determine the Gleason score as nodules will sometimes show higher grade disease which oncologically would be silly to ignore, and I use PSA at the time of biopsy. Of course, each patient is individual but this...
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Radiation Oncologist at Eisenhower Bighorn Radiation Oncology Center I also struggle since I encounter situations with ...
Radiation Oncologist at Vanderbilt-Ingram Cancer Center At our institution, if an MR-only biopsy is done a...
Answer from: Radiation Oncologist at Community Practice
Correct me if I am wrong, but there are 3 decisions that we make when we are stratifying patients into risk groups; 1. Should we add pelvic RT, 2. should we add ADT, 3.and using this information to show patients how poor surgery is for controlling their cancer(MSKCC & CAPRA). We have a large pri...