Prostate Magnetic Resonance Imaging Analyses, Clinical Parameters, and Preoperative Nomograms in the Prediction of Extraprostatic Extension.

INTRODUCTION: Proper planning of laparoscopic radical prostatectomy (RP) in patients with prostate cancer (PCa) is crucial to achieving good oncological results with the possibility of preserving potency and continence. AIM: The aim of this study was to identify the radiological and clinical parameters that can predict the risk of extraprostatic extension (EPE) for a specific site of the prostate. Predictive models and multiparametric magnetic resonance imaging (mpMRI) data from patients qualified for RP were compared. MATERIAL AND METHODS: The study included 61 patients who underwent laparoscopic RP. mpMRI preceded transrectal systematic and cognitive fusion biopsy. Martini, Memorial Sloan-Kettering Cancer Center (MSKCC), and Partin Tables nomograms were used to assess the risk of EPE. The area under the curve (AUC) was calculated for the models and compared. Univariate and multivariate logistic regression analyses were used to determine the combination of variables that best predicted EPE risk based on final histopathology. RESULTS: The combination of mpMRI indicating or suspecting EPE (odds ratio (OR) = 7.49 (2.31-24.27), p < 0.001) and PSA ≥ 20 ng/mL (OR = 12.06 (1.1-132.15), p = 0.04) best predicted the risk of EPE for a specific side of the prostate. For the prediction of ipsilateral EPE risk, the AUC for Martini's nomogram vs. mpMRI was 0.73 (p < 0.001) vs. 0.63 (p = 0.005), respectively (p = 0.131). The assessment of a non-specific site of EPE by MSKCC vs. Partin Tables showed AUC values of 0.71 (p = 0.007) vs. 0.63 (p = 0.074), respectively (p = 0.211). CONCLUSIONS: The combined use of mpMRI, the results of the systematic and targeted biopsy, and prostate-specific antigen baseline can effectively predict ipsilateral EPE (pT3 stage).

Analysis of the usefulness of magnetic resonance imaging and clinical parameters in the detection of prostate cancer in the first systematic biopsy combined with targeted cognitive biopsy.

INTRODUCTION: The study aimed to assess the suitability of multiparametric magnetic resonance prostate imaging (mpMRI) in combination with clinical parameters [prostate-specific antigen (PSA), digital rectal examination (DRE)] in the identification of men at risk of the presence of prostate cancer (PCa) and clinically significant prostate cancer (csPCa, Gleason Score ≥3+4) in the cognitive fusion with systematic prostate biopsy. MATERIAL AND METHODS: We retrospectively evaluated a population of 215 biopsy - naive patients with a clinical suspicion of prostate cancer. The results of mpMRI, DRE, PSA and biopsy were analyzed. MpMRI of the prostate according to the Prostate Imaging Reporting and Data System (PI-RADS) v.2.0 scheme preceded cognitive fusion and systematic transrectal prostate biopsy. Uni- and multivariable logistic regression analysis (MVA) was used to identify the variables determining the risk of detecting PCa overall and csPCa. RESULTS: In MVA, it was established that the combination of variables such as PSA level [odds ratio (OR) 1.195; p = 0.002], PI-RADS ≥3 (OR 7.7; p = 0.002), prostate volume (OR 0.98; p = 0.017) significantly determines the probability of PCa detection in biopsy, while for csPCa it is PSA level (OR 1.14; p = 0.004), DRE (+) (OR 5.75; p <0.001), PI-RADS ≥4 (OR 6.5; p <0.001). Analysis of mpMRI diagnostic value for PI-RADS ≥4 revealed better sensitivity (88.9% vs 82.6%) and better negative predictive value (NPV) (94.5% vs 82.4%) for detection of csPCa than for PCa overall. CONCLUSIONS: MpMRI results combining with DRE and PSA parameters help to identify men at high - or low risk of csPCa detection in the first - time biopsy.

Attitudes about Testicular Self-Examination among Polish Males.

INTRODUCTION: Epidemiological data indicate an increased incidence of testicular cancer (TC), making it the most common malignant tumor in men from aged 15-45. Oncological and urological associations recommend that men with specific TC risk factors should regularly perform a testicular self-exam (TSE). The aim of the study was to discover the attitudes among Polish males regarding TSE and factors (environmental, social, educational) that affect intention to perform TSE. METHODS: An original survey containing 21 questions was used to conduct a study among the Polish branch of VW (Volkswagen Poland) employees. RESULTS: A total of 522 fully completed questionnaires were collected. The mean age of the surveyed respondents was 32 years. Information about TC and how to perform TSE was obtained by 34.4% (n = 185) of the men. It was shown that the following factors increase men's intention to perform TSE: TC in their family member (p < 0.05; HR = 5.9; 95% CI: 1.5-23.0), GP's(General Practitioner) recommendations (p < 0.001; HR = 6.8; 95% CI: 3.2-14.3), concern expressed by their partner (p < 0.001; HR = 3.3; 95% CI: 2.1-5.3), and social campaigns (p < 0.001; HR = 2.6; 95% CI: 1.5-4.6). CONCLUSIONS: Approximately half of young polish males do not perform TSE. Access to information on TC prevention is limited. Further action is needed to improve men's awareness of TC and TSE.