A Recursive Partitioning Analysis Demonstrating Risk Subsets for 8-Year Biochemical Relapse After Margin-Positive Radical Prostatectomy Without Adjuvant Hormone or Radiation Therapy

Seyedin, Steven N.; Watkins, John M.; Mayo, Zachary; Snow, Anthony N.; Laszewski, M.; Russo, James Kyle; Mott, Sarah L.; Tracy, Chad R.; Smith, Mark C.; Buatti, John M.; Caster, Joseph M.

doi:10.1016/j.adro.2021.100778

Cited by 1 publication

(1 citation statement)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients were categorized according to absence or presence of early BF, defined as a PSA level >0.10 ng/mL 6 weeks after surgery (16) 2 the analysis of correlation between independent variables. We recall that P tests the correlation coefficient against 0, i.e., two variables are correlated if the result is greater than 0.5.…”

Section: Discussionmentioning

confidence: 99%

Role of magnetic resonance imaging for preoperative prediction of early biochemical failure in localized prostate cancer

Cassin¹,

Walker²,

Blanc³

et al. 2023

Quant Imaging Med Surg

View full text Add to dashboard Cite

Background: The purpose of our study was to assess preoperative clinical biological and Magnetic Resonance Imaging (MRI) predictive factors of early biochemical failure (BF), defined as persistence of significant post-operative plasmatic prostate specific antigen (PSA) level after radical prostatectomy (RP) in patients with localized prostate cancer (PCa).Methods: In a retrospective cohort study we included 142 patients from our university hospital with newly diagnosed PCa, who underwent 3T multiparametric MRI prior to RP. Only the MRI target lesions [Prostate Imaging Reporting and Data System (PIRADS) ≥3] with histological correspondence were considered significant. Clinical, biological, MRI and pathological preoperative data were studied.We performed univariate and multivariate logistic regression analysis to identify significant parameters associated with early BF.Results: Early BF occurred in 14% of patients (20/142). Patients with BF had higher PSA level at diagnosis, Gleason score, number of positive biopsies, size of the largest positive biopsy and higher National Comprehensive Cancer Network (NCCN) risk score (P<0.001 for all). According to MRI, they also had higher T stage and a higher size of capsular contact (P<0.001 for all). In contrast, there was no difference concerning neither ADC value, perfusion profile and zonal location of the index lesion. In multivariate analysis, the best combination of predictive factors of early BF was the association of preoperative Gleason score ≥4+3 {odds ratio (OR) =6.8 [1.4-32.5]; P=0.002} and T stage ≥3 on preoperative MRI {OR =17.4[3.2-94.9]; P<0.001} with an area under the curve (AUC) of 0.89 [99% confidence interval (CI): 0.77-1], a negative predictive value of 94% and a positive predictive value of 75%.Conclusions: Combination of simple preoperative biomarkers as Gleason score and T stage according to MRI accurately stratify the risk of early BF following RP. These results emphasize the pivotal role of preoperative MRI for the management of localized PCa.

show abstract

Section: Discussionmentioning

confidence: 99%