Contemporary Epstein Criteria with Biopsy-Naïve Multiparametric Magnetic Resonance Imaging to Prevent Incorrect Assignment to Active Surveillance in the PI-RADS Version 2.0 Era.
Ann Surg Oncol
; 25(12): 3510-3517, 2018 Nov.
Article
em En
| MEDLINE
| ID: mdl-30225837
ABSTRACT
PURPOSE:
The aim of this study is to evaluate the effectiveness of multiparametric magnetic resonance imaging (mp-MRI) in prostate cancer (PCa) patients with biopsy Gleason score ≤ 6 who may otherwise be assigned to active surveillance (AS). PATIENTS ANDMETHODS:
This was a retrospective study of 90 patients who underwent transrectal systematic biopsy for prostate cancer with Gleason score ≤ 6 without neoadjuvant therapy, with radical prostatectomy (RP) conducted between September 2009 and March 2018. All patients underwent prebiopsy mp-MRI. The prostate imaging reporting and data system (PI-RADS) version 2.0 score was evaluated. The correlation between imaging results and pathological findings was analyzed. We established models based on Epstein criteria with or without PI-RADS score and evaluated their ability for screening of potential PCa AS candidates.RESULTS:
Among 90 patients, 60 (66.7%) had upgrade (Gleason ≥ 7), 30 (33.3%) had extraprostatic extension, and 9 (10%) had seminal vesicle invasion on RP specimens. The rate of unfavorable disease was 67.8% (61 of 90). On multivariate analysis, independent risk factors for unfavorable disease were prostate-specific antigen density and PI-RADS score. The model based on Epstein criteria with PI-RADS score showed improved integrated discrimination improvement index and was superior to the classical Epstein criteria on decision curve analysis for screening potential prostate cancer AS candidates.CONCLUSIONS:
Multiparametric MRI with PIRADS 2.0 provides useful supplementary information to Epstein criteria, and may prevent incorrect assignment to active surveillance.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Prostatectomia
/
Neoplasias da Próstata
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Imageamento por Ressonância Magnética
/
Vigilância da População
/
Técnicas de Apoio para a Decisão
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Aged
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Ann Surg Oncol
Assunto da revista:
NEOPLASIAS
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
China