Temporary Health Impact of Prostate MRI and Transrectal Prostate Biopsy in Active Surveillance Prostate Cancer Patients |
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Authors: | Prasad R. Shankar Katherine E. Maturen Arvin K. George Tudor Borza Chandy Ellimoottil Jeffrey S. Montgomery John T. Wei Brian T. Denton Matthew S. Davenport |
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Affiliation: | 1. Department of Radiology, Michigan Medicine, Ann Arbor, Michigan;2. Michigan Radiology Quality Collaborative, Michigan Medicine, Ann Arbor, Michigan;3. Department of Urology, Michigan Medicine, Ann Arbor, Michigan;4. Department of Urology, University of Wisconsin, Madison, Wisconsin;5. Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, Michigan |
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Abstract: | PurposeTo assess the temporary health impact of prostate multiparametric MRI (mpMRI) and transrectal prostate biopsy in an active surveillance prostate cancer population.MethodsA two-arm institutional review board–approved HIPAA-compliant prospective observational patient-reported outcomes study was performed from November 2017 to July 2018. Inclusion criteria were men with Gleason 6 prostate cancer in active surveillance undergoing either prostate mpMRI or transrectal prostate biopsy. A survey instrument was constructed using validated metrics in consultation with the local patient- and family-centered care organization. Study subjects were recruited at the time of diagnostic testing and completed the instrument by phone 24 to 72 hours after testing. The primary outcome measure was summary testing-related quality of life (summary utility score), derived from the testing morbidities index (TMI) (scale: 0 = death and 1 = perfect health). TMI is stratified into seven domains, with each domain scored from 1 (no health impact) to 5 (extreme health impact). Testing-related quality-of-life measures in the two cohorts were compared with Mann-Whitney U test.ResultsIn all, 122 subjects were recruited, and 90% (110 of 122 [MRI 55 of 60, biopsy 55 of 62]) successfully completed the survey instrument. The temporary quality-of-life impact of transrectal biopsy was significantly greater than that of prostate mpMRI (0.82, 95% confidence interval [CI] 0.79-0.85, versus 0.95, 95% CI 0.94-0.97; P < .001). The largest mean domain-level difference was for intraprocedural pain (transrectal biopsy 2.6, 95% CI 2.4-2.8, versus mpMRI 1.3, 95% CI 1.1-1.5; P < .001).ConclusionTransrectal prostate biopsy has greater temporary health impact (lower testing-related quality-of-life measure) than prostate mpMRI. |
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Keywords: | Corresponding author and reprints: Prasad R. Shankar, MD, University of Michigan, Department of Radiology, 1500 E Medical Center Drive, University Hospital, B1 D530H, Ann Arbor, MI 48109 Quality of life patient-reported outcomes prostate cancer testing-related utilities active surveillance |
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