International multi-site initiative to develop an MRI-inclusive nomogram for side-specific prediction of extraprostatic extension of prostate cancer Journal Article


Authors: Wibmer, A. G.; Kattan, M. W.; Alessandrino, F.; Baur, A. D. J.; Boesen, L.; Franco, F. B.; Bonekamp, D.; Campa, R.; Cash, H.; Catalá, V.; Crouzet, S.; Dinnoo, S.; Eastham, J.; Fennessy, F. M.; Ghabili, K.; Hohenfellner, M.; Levi, A. W.; Ji, X.; Løgager, V.; Margolis, D. J.; Moldovan, P. C.; Panebianco, V.; Penzkofer, T.; Puech, P.; Radtke, J. P.; Rouvière, O.; Schlemmer, H. P.; Sprenkle, P. C.; Tempany, C. M.; Vilanova, J. C.; Weinreb, J.; Hricak, H.; Shukla-Dave, A.
Article Title: International multi-site initiative to develop an MRI-inclusive nomogram for side-specific prediction of extraprostatic extension of prostate cancer
Abstract: Background: To develop an international, multi-site nomogram for side-specific prediction of extraprostatic extension (EPE) of prostate cancer based on clinical, biopsy, and magnetic resonance imaging-(MRI) derived data. Methods: Ten institutions from the USA and Europe contributed clinical and side-specific biopsy and MRI variables of consecutive patients who underwent prostatectomy. A logistic regression model was used to develop a nomogram for predicting side-specific EPE on prostatectomy specimens. The performance of the statistical model was evaluated by bootstrap resampling and cross validation and compared with the performance of benchmark models that do not incorporate MRI findings. Results: Data from 840 patients were analyzed; pathologic EPE was found in 320/840 (31.8%). The nomogram model included patient age, prostate-specific antigen density, side-specific biopsy data (i.e., Gleason grade group, percent positive cores, tumor extent), and side-specific MRI features (i.e., presence of a PI-RADSv2 4 or 5 lesion, level of suspicion for EPE, length of capsular contact). The area under the receiver operating characteristic curve of the new, MRI-inclusive model (0.828, 95% confidence limits: 0.805, 0.852) was significantly higher than that of any of the benchmark models (p < 0.001 for all). Conclusions: In an international, multi-site study, we developed an MRI-inclusive nomogram for the side-specific prediction of EPE of prostate cancer that demonstrated significantly greater accuracy than clinical benchmark models. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
Keywords: magnetic resonance imaging; prostate cancer; nomogram; clinical staging; extraprostatic tumor extension
Journal Title: Cancers
Volume: 13
Issue: 11
ISSN: 2072-6694
Publisher: MDPI  
Date Published: 2021-06-01
Start Page: 2627
Language: English
DOI: 10.3390/cancers13112627
PROVIDER: scopus
PMCID: PMC8198352
PUBMED: 34071842
DOI/URL:
Notes: Article -- Export Date: 1 July 2021 -- Source: Scopus
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  1. Hedvig Hricak
    421 Hricak
  2. James Eastham
    541 Eastham
  3. Amita Dave
    140 Dave
  4. Andreas Georg Wibmer
    54 Wibmer