ArticleThe Journal of urology2026
Noninvasive Urine Test Predicts Grade Group Upgrading in Patients on Active Surveillance for Prostate Cancer: Multisite Validation and Comparison with MRI.
Article in The Journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
- Commented on by
Authors and funding
38 authors.
Funding
Abstract
purposeWe developed and externally validated a nondigital rectal examination urine test to inform whether biopsy is necessary in patients undergoing active surveillance (AS). Performance and clinical consequences of testing were directly compared with multiparametric MRI (mpMRI). MATERIALS AND
methodsBiomarker models (MyProstateScore 2.0-Active Surveillance [MPS2-AS]) were derived to predict upgrading to Grade Group (GG) ≥ 3 and GG ≥ 2 and externally validated across 11 practices. Urine was prospectively collected, and patients underwent ≥ 12-core systematic biopsy plus targeted biopsy of Prostate Imaging Reporting and Data System (PI-RADS) ≥ 3 lesions. Diagnostic performance and clinical consequences of urinary testing to determine the need for biopsy were compared with mpMRI.
resultsThe validation cohort included 330 patients with GG1 cancer scheduled for AS biopsy. Overall, 280 (85%) patients had prebiopsy mpMRI, of which 130 (46%) were PI-RADS 1 to 2, 42 (15%) were PI-RADS 3, and 108 (39%) were PI-RADS 4 to 5. On biopsy, 31 (9.4%) patients upgraded to GG ≥ 3 and 123 (37%) to GG ≥ 2. MPS2-AS provided higher area under the receiver operating characteristic curve than mpMRI for upgrading to both GG ≥ 3 (0.82 vs 0.73) and GG ≥ 2 (0.74 vs 0.64). Clinically, prebiopsy MPS2-AS would have avoided 64% of unnecessary biopsies while failing to detect only 3.2% of GG ≥ 3 upgrades and 4.9% of GG ≥ 2 upgrades. By contrast, the use of PI-RADS ≥ 3 would have failed to detect 18% of GG ≥ 3 upgrades, 35% of GG ≥ 2 upgrades, and avoided fewer unnecessary biopsies (50%). Performance of MPS2-AS was consistent across clinically pertinent subgroups (confirmatory and surveillance biopsy, Black and non-Black patients).
conclusionsIn a multisite AS population, urinary MPS2-AS provided highly accurate and actionable testing for GG ≥ 3 and GG ≥ 2 upgrading, meaningfully outperforming mpMRI on direct comparison. These findings suggest that noninvasive monitoring with MPS2-AS could reduce the need for scheduled biopsies and serial mpMRI.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.