Characteristics of Anteriorly Located Prostate Cancer and the Usefulness of Multiparametric Magnetic Resonance Imaging for Diagnosis

Kim, Myong; Choi, Seung-Kwon; Park, Myungchan; Shim, Myungsun; Song, Cheryn; Jeong, In Gab; Hong, Jun Hyuk; Kim, Choung‐Soo; Ahn, Hanjong

doi:10.1016/j.juro.2016.03.075

Cited by 24 publications

(30 citation statements)

References 26 publications

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“…With regard to clinical and pathologic features of csPCa developed after nMRI in patients who underwent RP, we found, as previously reported, that prostatitis and benign prostatic hyperplasia can mask PCa [22] and that small tumors near the anterior horn can be missed at mpMRI [27], possibly indicating that the reader experience is extremely important to avoid false negative, as also shown by the PROMIS trial, which was based on quality control of mpMRI and systematic training of radiologists [12].…”

Section: Discussionsupporting

confidence: 77%

Negative Multiparametric Magnetic Resonance Imaging for Prostate Cancer: What's Next?

Panebianco

Barchetti

Simone³

et al. 2018

European Urology

155

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Section: Discussionsupporting

confidence: 77%

Negative Multiparametric Magnetic Resonance Imaging for Prostate Cancer: What's Next?

Panebianco

Barchetti

Simone³

et al. 2018

European Urology

155

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“…Especially, lesions in the apex or anterior of the prostate are difficult to find. In these cases, MRI is useful for identifying occult anterior lesion cancers [26]. However, the purpose of the follow-up MRI in our study was not to detect upgrading or upstaging but to make a decision about early biopsy or to make target biopsy easier.…”

Section: Discussionmentioning

confidence: 96%

Updated clinical results of active surveillance of very-low-risk prostate cancer in Korean men: 8 years of follow-up

Shin

Jung

et al. 2017

Investig Clin Urol

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PurposeUpdate and reanalysis of our experience of active surveillance (AS) for prostate cancer (PCa) in Korea.Materials and MethodsA prospective, single-arm, cohort study was initiated in January 2008. Patients were selected according to the following criteria: Gleason sum ≤6 with single positive core with ≤30% core involvement, clinical stage≤T1c, prostate-specific antigen (PSA)≤10 ng/mL, and negative magnetic resonance imaging (MRI) results. Follow-up was by PSA measurement every 6 months, prostate biopsies at 1 year and then every 2–3 years, and MRI every year.ResultsA total of 80 patients were treated with AS. Median follow-up was 52 months (range, 6–96 months). Of them, 39 patients (48.8%) discontinued AS for various reasons (17, disease progression; 9, patient preference; 10, watchful waiting due to old age; 3, follow-up loss; 2, death). The probability of progression was 14.0% and 42.9% at 1 and 3 years, respectively. Overall survival was 97.5%. PCa-specific survival was 100%. Progression occurred in 5 of 7 patients (71.4%) with a prostate volume less than 30 mL, 7 of 40 patients (17.5%) with a prostate volume of 30 to 50 mL, and 5 of 33 patients (15.2%) with a prostate volume of 50 mL or larger. There were 8 detectable positive lesions on follow-up MRI. Of them, 6 patients (75%) had actual progressed disease.ConclusionsSmall prostate volume was associated with a tendency for cancer progression. MRI was helpful and promising for managing AS. Nevertheless, regular biopsies should be performed. AS is a safe and feasible treatment option for very-low-risk PCa in Korea. However, AS should continue to be used in carefully selected patients.

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“…African Americans are more likely to have anterior tumors, which are more likely to have Gleason upgrading ( Sundi et al, 2014 ). However, Kim et al recently reported that anterior tumors have similar extracapsular extension, positive margins, and lymph node invasion compared with posterior tumors and that anterior tumors have significantly higher rates of 5-year biochemical-free recurrence survival ( Kim et al, 2016 ). They hypothesized that a barrier formed by the anterior horn of the peripheral zone or anterior fibromuscular stroma and fewer lymphatics and blood vessels could be the reason for such results.…”

Section: Discussionmentioning

confidence: 99%

African American Men With Low-Risk Prostate Cancer Are Candidates for Active Surveillance: The Will-Rogers Effect?

Moul

2017

Am J Mens Health

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It is controversial whether African American men(AAM) with low-risk prostate cancer (PC) should be placed on active surveillance (AS). Recent literature indicates AAM diagnosed with low-risk disease have increased pathologic upgrading and disease progression. We evaluated the surgical pathology of AAM and Caucasians who underwent prostatectomy to assess the suitability of AAM for AS. We retrospectively reviewed 1,034 consecutive men who underwent open prostatectomy between 2004 and 2015; 345 Caucasians and 58 AAM met the American Urological Association criteria for low-risk PC. We excluded from analysis two men whose prostatectomies were aborted. Chi-square test, Fisher’s exact test, and Wilcoxon rank sum test were used for statistical analysis. AAM with low-risk PC have a lower rate of surgical upgrading and similar rates of adverse pathology compared with Caucasians. 29.8% of AAM (17/57) diagnosed with low-risk disease but 44.5% of Caucasians (153/344) had disease upgrading at prostatectomy (p < .04), although AAM overall were less likely to be clinically diagnosed with low-risk cancer (33.1 vs. 41.7%, p < .05). AAM with low-risk pathology were younger (median 55 vs. 59 years, p < .001) and had smaller prostates (32 vs. 35 g, p < .04). AAM with preoperative low-risk disease have lower rates of surgical upgrading and similar adverse pathology compared with Caucasians. There may be a Will-Rogers effect as AAM with aggressive disease appear more likely to be stratified into intermediate- and high-risk groups, leaving those AAM diagnosed with low-risk disease fully eligible for AS. Our results support that AS for AAM should remain a viable option.

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Characteristics of Anteriorly Located Prostate Cancer and the Usefulness of Multiparametric Magnetic Resonance Imaging for Diagnosis

Cited by 24 publications

References 26 publications

Negative Multiparametric Magnetic Resonance Imaging for Prostate Cancer: What's Next?

Negative Multiparametric Magnetic Resonance Imaging for Prostate Cancer: What's Next?

Updated clinical results of active surveillance of very-low-risk prostate cancer in Korean men: 8 years of follow-up

African American Men With Low-Risk Prostate Cancer Are Candidates for Active Surveillance: The Will-Rogers Effect?

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