Can we improve the preoperative prediction of prostate cancer recurrence with multiparametric MRI? Journal Article
| Authors: | Capogrosso, P.; Vertosick, E. A.; Benfante, N. E.; Sjoberg, D. D.; Vickers, A. J.; Eastham, J. A. |
| Article Title: | Can we improve the preoperative prediction of prostate cancer recurrence with multiparametric MRI? |
| Abstract: | Introduction: The use of multiparametric magnetic resonance imaging (mpMRI) to assess prostate cancer (PCa) has increased over the past decade. We aimed to assess if preoperative mpMRI lesion score, a variable routinely available for men undergoing pre-biopsy MRI, improves the performance of commonly used preoperative predictive models for PCa recurrence. Patients and Methods: We analyzed data from 372 patients with PCa treated with radical prostatectomy in 2012 to 2017 and assessed with pre-biopsy mpMRI within 6 months prior to surgery. Suspicious areas for cancer were scored on a standardized 5-point scale. Cox regression was used to assess the association between mpMRI score and the risk of postoperative biochemical recurrence. Two different models were tested accounting for factors included in the Kattan nomogram and in the D'Amico risk-classification. Results: Overall, 53% and 30% of patients were found with a lesion scored 4 or 5 at pre-biopsy mpMRI, respectively. Risk varied widely by mpMRI (29% 2-year risk of biochemical recurrence for a score of 5 vs. 5% for a score of 1-2), and mpMRI score was associated with large hazard ratios after adjusting for stage, grade, and prostate-specific antigen: 1.66, 1.96, and 2.71 for scores 3, 4, and 5, respectively. However, 95% confidence intervals were very wide (0.19-14.20, 0.26-14.65, and 0.36-20.55, respectively) and included 1. Conclusions: Our data did not show that preoperative models, commonly used to assess PCa risk, were improved after including the pre-biopsy mpMRI score. However, the value of pre-biopsy mpMRI to improve preoperative risk models should be investigated in larger data sets. © 2019 Elsevier Inc. We looked at the clinical significance of including the multiparametric magnetic resonance imaging (mpMRI) lesion score in common predictive tools for biochemical recurrence after surgery for prostate cancer. Higher mpMRI scores were associated with higher risk of biochemical recurrence, although the association was not statistically significant and the predictive models were not improved by including the mpMRI score. The value of pre-biopsy mpMRI to improve preoperative risk models should be further investigated. © 2019 Elsevier Inc. |
| Keywords: | adult; aged; survival analysis; survival rate; major clinical study; cancer recurrence; postoperative period; disease free survival; recurrence risk; preoperative evaluation; prostate specific antigen; cohort analysis; recurrence; prediction; risk assessment; prostate cancer; prostatectomy; psa; biochemical recurrence; mri; multiparametric magnetic resonance imaging; human; male; article; likert scale; predictive tool |
| Journal Title: | Clinical Genitourinary Cancer |
| Volume: | 17 |
| Issue: | 4 |
| ISSN: | 1558-7673 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2019-08-01 |
| Start Page: | e745 |
| End Page: | e750 |
| Language: | English |
| DOI: | 10.1016/j.clgc.2019.03.022 |
| PUBMED: | 31201051 |
| PROVIDER: | scopus |
| PMCID: | PMC7524609 |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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