. 2022 Feb;16(2):16–23. doi: 10.5489/cuaj.7425

Table 3.

Responses regarding main comments from targeted peer-review

Main comments	Responses
One thing that I was uncertain of is the nature of a “negative biopsy” (i.e., no prostate cancer seen or does a negative biopsy include GG 1 prostate cancer). It might be worthwhile to make a disclaimer that this guideline is not addressing the use of mpMRI for men diagnosed with cisPCa on previous biopsies. I wonder if a quick sentence to clarify that may ensure clinicians are not expecting recommendations on the use of mpMRI in patients on active surveillance.	We added a phrase: “Patients with an elevated risk of csPCa (defined as ISUP GG ≥2), as estimated by available clinical information and tools, such as risk calculators and nomograms, of who are A) biopsy-naive or B) have had a prior negative TRUS-SB, defined as no prostate cancer on biopsy of any grade group.” A definition has been added under qualifying statements for Recommendation 2: “Prior negative TRUS-SB is defined as no cancer of any GG on prior biopsy.”

Main comments

Responses

One thing that I was uncertain of is the nature of a “negative biopsy” (i.e., no prostate cancer seen or does a negative biopsy include GG 1 prostate cancer). It might be worthwhile to make a disclaimer that this guideline is not addressing the use of mpMRI for men diagnosed with cisPCa on previous biopsies. I wonder if a quick sentence to clarify that may ensure clinicians are not expecting recommendations on the use of mpMRI in patients on active surveillance.

We added a phrase:
“Patients with an elevated risk of csPCa (defined as ISUP GG ≥2), as estimated by available clinical information and tools, such as risk calculators and nomograms, of who are A) biopsy-naive or B) have had a prior negative TRUS-SB, defined as no prostate cancer on biopsy of any grade group.”
A definition has been added under qualifying statements for Recommendation 2:
“Prior negative TRUS-SB is defined as no cancer of any GG on prior biopsy.”

cisPCa: clinically insignificant prostate cancer; cs: clinically significant; ISUP GG: International Society of Urologic Pathology [ISUP] grade group; mpMRI: multiparametric magnetic resonance imaging; TRUS-SB: transrectal ultrasound-guided systematic biopsy.