Impact of multiparametric MRI and prostate biopsies on anxiety and quality of life in men with suspected prostate cancer.

Objectives: To study the impact of the new MRI pathway and conventional transrectal ultrasound-guided systematic biopsies (TRUSGB) on anxiety and HRQoL in men with suspected PCa. Materials and methods: A secondary analysis was performed of a randomized clinical trial including 626 biopsy-naïve patients. All patients underwent mpMRI and TRUSGB. Men with suspicious lesions on mpMRI underwent MRGB prior to TRUSGB. Anxiety was measured by State-Trait Anxiety Inventory-Trait Scale (STAI-6), completed at baseline, directly after mpMRI, MRGB, TRUSGB, after two/three weeks, and six months. HRQoL was measured by EuroQol (EQ-5D-5L), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (QLQ-C30) and Prostate Cancer Module (QLQ-PR25). Outcomes were compared between patients that underwent mpMRI and TRUSGB and patients that underwent mpMRI, MRGB and TRUSGB. Differences were considered relevant if the 95% confidence interval exceeded the minimal important clinical difference. Results: No relevant differences were seen in anxiety scores and generic HRQoL at different time points in patients that underwent mpMRI, TRUSGB and MRGB compared to patients that underwent mpMRI and TRUSGB. Patients that underwent mpMRI, MRGB and TRUSGB reported lower incontinence aid and hormonal treatment-related symptom scores after 6 months compared to patients that underwent mpMRI and TRUSGB. Conclusions: In men suspected of PCa, no differences were observed in anxiety levels or generic HRQoL scores across different diagnostic pathways. However, lower PCa-specific HRQoL subscores were noted in patients who underwent mpMRI, MRGB and TRUSGB.