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Pathological and 3 Tesla Volumetric Magnetic Resonance Imaging Predictors of Biochemical Recurrence after Robotic Assisted Radical Prostatectomy: Correlation with Whole Mount Histopathology.
Tan, Nelly; Shen, Luyao; Khoshnoodi, Pooria; Alcalá, Héctor E; Yu, Weixia; Hsu, William; Reiter, Robert E; Lu, David Y; Raman, Steven S.
Afiliação
  • Tan N; School of Medicine University of California-Riverside, Riverside, California; Department of Radiology, Loma Linda University, Loma Linda, California. Electronic address: nelly.tan@ucr.edu.
  • Shen L; Department of Radiological Sciences, University of California-Los Angeles, Los Angeles, California.
  • Khoshnoodi P; Department of Radiological Sciences, University of California-Los Angeles, Los Angeles, California.
  • Alcalá HE; Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, New York.
  • Yu W; Computing Technology Research Laboratory, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California.
  • Hsu W; Department of Radiology, Loma Linda University, Loma Linda, California.
  • Reiter RE; Department of Urology, University of California-Los Angeles, Los Angeles, California.
  • Lu DY; Department of Pathology, University of California-Los Angeles, Los Angeles, California.
  • Raman SS; Department of Radiology, Loma Linda University, Loma Linda, California.
J Urol ; 199(5): 1218-1223, 2018 05.
Article em En | MEDLINE | ID: mdl-29128577
ABSTRACT

PURPOSE:

We sought to identify the clinical and magnetic resonance imaging variables predictive of biochemical recurrence after robotic assisted radical prostatectomy in patients who underwent multiparametric 3 Tesla prostate magnetic resonance imaging. MATERIALS AND

METHODS:

We performed an institutional review board approved, HIPAA (Health Insurance Portability and Accountability Act) compliant, single arm observational study of 3 Tesla multiparametric magnetic resonance imaging prior to robotic assisted radical prostatectomy from December 2009 to March 2016. Clinical, magnetic resonance imaging and pathological information, and clinical outcomes were compiled. Biochemical recurrence was defined as prostate specific antigen 0.2 ng/cc or greater. Univariate and multivariate regression analysis was performed.

RESULTS:

Biochemical recurrence had developed in 62 of the 255 men (24.3%) included in the study at a median followup of 23.5 months. Compared to the subcohort without biochemical recurrence the subcohort with biochemical recurrence had a greater proportion of patients with a high grade biopsy Gleason score, higher preoperative prostate specific antigen (7.4 vs 5.6 ng/ml), intermediate and high D'Amico classifications, larger tumor volume on magnetic resonance imaging (0.66 vs 0.30 ml), higher PI-RADS® (Prostate Imaging-Reporting and Data System) version 2 category lesions, a greater proportion of intermediate and high grade radical prostatectomy Gleason score lesions, higher pathological T3 stage (all p <0.01) and a higher positive surgical margin rate (19.3% vs 7.8%, p = 0.016). On multivariable analysis only tumor volume on magnetic resonance imaging (adjusted OR 1.57, p = 0.016), pathological T stage (adjusted OR 2.26, p = 0.02), positive surgical margin (adjusted OR 5.0, p = 0.004) and radical prostatectomy Gleason score (adjusted OR 2.29, p = 0.004) predicted biochemical recurrence.

CONCLUSIONS:

In this cohort tumor volume on magnetic resonance imaging and pathological variables, including Gleason score, staging and positive surgical margins, significantly predicted biochemical recurrence. This suggests an important new imaging biomarker.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Prostatectomia / Neoplasias da Próstata / Imageamento por Ressonância Magnética / Procedimentos Cirúrgicos Robóticos / Recidiva Local de Neoplasia Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans / Male / Middle aged Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Prostatectomia / Neoplasias da Próstata / Imageamento por Ressonância Magnética / Procedimentos Cirúrgicos Robóticos / Recidiva Local de Neoplasia Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans / Male / Middle aged Idioma: En Ano de publicação: 2018 Tipo de documento: Article