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Long-Term Risk of Clinical Progression Utilizing Magnetic Resonance Imaging Findings of Locally Recurrent Prostate Cancer in Patients with Biochemical Recurrence following Radical Prostatectomy.
Tanaka, Takashi; Kawashima, Akira; Rangel, Laureano J; Schulte, Phillip J; Froemming, Adam T; King, Bernard F; Mynderse, Lance A; Karnes, R Jeffrey.
Afiliação
  • Tanaka T; Department of Radiology, Mayo Clinic, Scottsdale, Arizona.
  • Kawashima A; Current address: Department of Radiology, Okayama City Hospital, Okayama, Japan.
  • Rangel LJ; Department of Radiology, Mayo Clinic, Scottsdale, Arizona.
  • Schulte PJ; Department of Radiology, Mayo Clinic, Rochester, Minnesota.
  • Froemming AT; Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
  • King BF; Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
  • Mynderse LA; Department of Radiology, Mayo Clinic, Rochester, Minnesota.
  • Karnes RJ; Department of Radiology, Mayo Clinic, Rochester, Minnesota.
J Urol ; 207(5): 1038-1047, 2022 05.
Article em En | MEDLINE | ID: mdl-34981952
PURPOSE: Our goal was to evaluate the long-term prognostic value of magnetic resonance imaging of the prostatectomy bed in patients with biochemical recurrence after radical prostatectomy for prostate cancer. MATERIALS AND METHODS: Men with biochemical recurrence after radical prostatectomy who were studied by prostatectomy bed magnetic resonance imaging for suspected local recurrence were retrospectively evaluated. Locally recurrent tumors were noted and measured from imaging reports. Patients with nodal/bone lesions at the time of imaging were excluded. Kaplan-Meier and Cox regression analyses were used to assess systemic progression-free and prostate cancer-specific survival. RESULTS: A total of 896 men were enrolled and the imaging positive and negative groups for local recurrent tumor consisted of 441 and 455 men, respectively. On univariate analysis, preoperative prostate specific antigen (p=0.02), clinical tumor stage (p=0.006), pathological Gleason score from prostatectomy (p=0.02), subsequent salvage radiotherapy (p <0.001), biochemical recurrence to magnetic resonance imaging time interval (p <0.001), age at magnetic resonance imaging (p=0.047) and prostate specific antigen at magnetic resonance imaging (p <0.001) were significantly different between magnetic resonance imaging positive and negative groups. Patients with negative magnetic resonance imaging results had worse systemic progression-free survival rates (p=0.025) and better prostate cancer-specific survival (p=0.016) than those with recurrence. Larger lesion size significantly increased risk of prostate cancer death (hazard ratio: 1.07; p <0.001). On multivariable analysis, pathological Gleason scores ≥7 were independent prognostic factors of systemic progression (p <0.05). CONCLUSIONS: Prostatectomy bed magnetic resonance imaging provides long-term prognostic information for the evaluation of patients with biochemical recurrence after prostatectomy. Post-prostatectomy patients with recurrent lesions on imaging had longer progression-free survival but shorter prostate cancer-specific survival compared to those without lesions. Additionally, those with larger lesions were associated with poorer cancer-specific survival.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Antígeno Prostático Específico Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans / Male Idioma: En Revista: J Urol Ano de publicação: 2022 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Antígeno Prostático Específico Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans / Male Idioma: En Revista: J Urol Ano de publicação: 2022 Tipo de documento: Article País de publicação: Estados Unidos