Prostate cancer with germline pathogenic variants: more PI-RADS 5 and extra-prostatic extension on MRI

Prostate cancer patients with germline pathogenic variants had more PI-RADS 5 MRI lesions (OR 2.7; CI 1.5–4.9) and grade 3 extra-prostatic extension (OR 3.0; CI 1.5–5.8) than sporadic controls, though PI-RADS ≥3 rates were similar.

• In this single-center retrospective case-control study, pathogenic variant carriers and sporadic controls had similar rates of positive MRI (PI-RADS ≥3: 98% vs 96%, p=0.70), but carriers more often had PI-RADS 5 lesions and grade 3 extra-prostatic extension.
• At prostatectomy, a higher proportion of pathogenic variant carriers were reclassified to a higher-grade group (37% vs 20%, p=0.046).
• The most frequent variants were CHEK2 (21.0%), BRCA2 (19.4%), ATM (17.7%), and Lynch syndrome-associated genes (17.7%); the single-center retrospective design limits generalizability.

Automated summary

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