Preoperative Multiparametric Magnetic Resonance Imaging Predicts Biochemical Recurrence in Prostate Cancer after Radical ProstatectomyReport as inadecuate




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Objectives

To evaluate the utility of preoperative multiparametric magnetic resonance imaging MP-MRI in predicting biochemical recurrence BCR following radical prostatectomy RP.

Materials-Methods

From March 2007 to January 2015, 421 consecutive patients with prostate cancer PCa underwent preoperative MP-MRI and RP. BCR-free survival rates were estimated using the Kaplan-Meier method. Cox proportional hazards models were used to identify clinical and imaging variables predictive of BCR. Logistic regression was performed to generate a nomogram to predict three-year BCR probability.

Results

Of the total cohort, 370 patients met inclusion criteria with 39 10.5% patients experiencing BCR. On multivariate analysis, preoperative prostate-specific antigen PSA p = 0.01, biopsy Gleason score p = 0.0008, MP-MRI suspicion score p = 0.03, and extracapsular extension on MP-MRI p = 0.03 were significantly associated with time to BCR. A nomogram integrating these factors to predict BCR at three years after RP demonstrated a c-index of 0.84, outperforming the predictive value of Gleason score and PSA alone c-index 0.74, p = 0.02.

Conclusion

The addition of MP-MRI to standard clinical factors significantly improves prediction of BCR in a post-prostatectomy PCa cohort. This could serve as a valuable tool to support clinical decision-making in patients with moderate and high-risk cancers.



Author: Richard Ho , Mohummad M. Siddiqui , Arvin K. George, Thomas Frye, Amichai Kilchevsky, Michele Fascelli, Nabeel A. Shakir, Raju Ch

Source: http://plos.srce.hr/



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