Prognostic Implications of Multiparametric Magnetic Resonance Imaging and Concomitant Systematic Biopsy in Predicting Biochemical Recurrence After Radical Prostatectomy in Prostate Cancer Patients Diagnosed with Magnetic Resonance Imaging–targeted Biopsy

Gandaglia, Giorgio; Ploussard, Guillaume; Valério, Massimo; Marra, Giancarlo; Moschini, Marco; Martini, Alberto; Roumiguié, M.; Fossati, Nicola; Stabile, Armando; Beauval, Jean-Baptiste; Malavaud, Bernard; Scuderi, Simone; Barletta, Francesco; Afferi, Luca; Rakauskas, Arnas; Gontero, Paolo; Mattei, Agostino; Montorsi, Francesco; Briganti, Alberto

doi:10.1016/j.euo.2020.07.008

Cited by 38 publications

(26 citation statements)

References 30 publications

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“…The results obtained indicate that preoperative mpMRI may be a useful tool in local staging of PCa and for the prediction of recurrence; they are to a large extent consistent with the results of other similar studies [7,8,15,16]. The mpMRI parameters analyzed by other researchers included: PIRADS score, volume and location of index lesions, presence of EPE, and/or SVI.…”

Section: Discussionsupporting

confidence: 85%

“…Therefore, the results obtained in our study indicate that mpMRI may improve the prediction of possible disease recurrence by improving local disease staging. In a study with a similar methodology, conducted on a large group of respondents (n = 804), Gandalgia et al proved that preoperative information obtained from mpMRI and the report of systematic biopsy combined with a targeted biopsy based on mpMRI allows stratification of PCa recurrence after RP [15]. When assessing the influence of preoperative factors on BCR, Manceau et al also proved that patients with EPE(+) diagnosed in mpMRI at the treatment planning stage more frequently experience BCR after RP [16].…”

Section: Discussionmentioning

confidence: 99%

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MRI utility in predicting extraprostatic extension of prostate cancer and biochemical recurrence after radical prostatectomy

Majchrzak¹,

Cieśliński²,

Milecki

et al. 2021

Nowotwory. Journal of Oncology

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Introduction. The study aimed to evaluate the performance of multiparametric magnetic resonance imaging (mpMRI) and the Martini model to predict extraprostatic extension (EPE) and biochemical recurrence (BCR) of prostate cancer (PCa). Materials and methods. 61 patients underwent a radical laparoscopic prostatectomy. The preoperative risk of EPE was determined using mpMRI and the Martini model. Results. MpMRI predicts the presence of EPE of PCa with a sensitivity and specificity of 47.4% and 85.7%, respectively (AUC 0.66, 95% CI: 0.51-0.82, p = 0.046). The Martini model's sensitivity was higher, but the specificity was lower than that of mpMRI and was 84.2% and 66.7%, respectively (AUC 0.78, 95% CI: 0.66-0.89, p < 0.001). Univariate and multivariate Cox analysis indicated that EPE in mpMRI (HR 6.6, 95% CI: 1.8-24.1), and the presence of positive surgical margins (PSM) (HR 7.1, 95% CI: 1.9-26.7) are independent factors increasing the probability of BCR. Conclusions. MpMRI and Martini model are valuable tools in local staging of PCa, managing and predicting the oncological treatment outcomes of patients with PCa.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

MRI utility in predicting extraprostatic extension of prostate cancer and biochemical recurrence after radical prostatectomy

Majchrzak¹,

Cieśliński²,

Milecki

et al. 2021

Nowotwory. Journal of Oncology

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“…For example, a multivariable model including MRI PI-RADS, along with clinical and pathological variables outperformed the European Association of Urology classification and the Cancer of the Prostate Risk Assessment (CAPRA) score for predicting BCR (c-index: 77% vs 62% vs 60%, respectively). 22 Moreover, in another study, 36 p[0.02). 37 Moreover, these findings are consistent with a recently published systematic review and meta-analysis which catalogued associations between MRI findings and oncologic outcome across a range of reporting rubrics, MRI features and oncologic endpoints.…”

Section: Discussionmentioning

confidence: 98%

The Prognostic Association of Prostate MRI PI-RADS™ v2 Assessment Category and Risk of Biochemical Recurrence after Definitive Local Therapy for Prostate Cancer: A Systematic Review and Meta-Analysis

et al. 2021

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Study Need and Importance: Despite the wide acceptance of Prostate ImagingeReporting and Data System version 2 (PI-RADS v2) as a reporting system for prostate magnetic resonance imaging (MRI), less is known about its prognostic significance. This study aimed to synthesize the evidence concerning the association between PI-RADS v2 and the risk of biochemical recurrence (BCR) after primary definitive therapy of prostate cancer. What We Found: Out of 9 included studies 8 were conducted in the context of radical prostatectomy and 1 post-radiation. Higher PI-RADS v2 scores were consistently associated with BCR after definitive treatment with pooled HR of 3.19 (95% CI 2.28e4.45; p <0.01) Limitations: Included studies were retrospective and unblinded in nature, potentially contributing biases in terms of treatment selection and surveillance. Furthermore, PI-RADS v2 was analyzed as continuous and categorized variables with various cut-offs, which were chosen based on data availability, study design, and statistical methods. In

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“…By targeting the index lesion, which is considered the main determinant of PCa behavior [ 6 ], MRI-guided biopsy should lead to a more accurate prediction of the final pathologic grading and oncologic outcomes after treatment. Gandaglia et al have shown that the combination of MRI and MRI-targeted biopsy with systematic biopsy data into a predictive model has higher accuracy for the prediction of biochemical recurrence following RP (77%) when compared to current risk stratification (62%) [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Combined Systematic and MRI-US Fusion Prostate Biopsy Has the Highest Grading Accuracy When Compared to Final Pathology

et al. 2021

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Background and objectives: Systematic prostate biopsy (SB) has a low Gleason group (GG) accuracy when compared to final pathology. This may negatively impact the inclusion of patients into specific risk groups and treatment choice. The aim of our study was to assess the GG accuracy of magnetic resonance imaging-ultrasound (MRI-US) fusion prostate biopsy. Materials and Methods: Of a cohort of minimally invasive radical prostatectomy (RP), we selected all patients who were diagnosed with prostate cancer (PCa) via MRI-US fusion biopsy (n = 115). Results: Combined biopsy had the highest rate for GG concordance (61.7% vs. 60.4% for SB vs. 45.3% for MRI-US fusion biopsy) and the lowest for upgrading (20.9% vs. 24.5% for SB vs. 34.9% for MRI-US fusion biopsy), p < 0.0001. No clinical data were predictive for upgrading or downgrading at final pathology. Locally advanced PCa was associated with a high Prostate Imaging-Reporting and Data System (PIRADS) score (p = 0.0014) and higher percentages of positive biopsy cores (PBC)/targeted (p = 0.0002) and PBC/total (p = 0.01). Positive surgical margins were correlated with higher percentages of PBC/systematic (p = 0.003) and PBC/total (p = 0.009). Conclusions: Pre-biopsy prostate MRI improves GG concordance between biopsy and RP. Combined biopsy provides the highest grading accuracy when compared to final pathology. Targeted and systematic biopsy data are predictive for adverse pathologic outcomes.

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Prognostic Implications of Multiparametric Magnetic Resonance Imaging and Concomitant Systematic Biopsy in Predicting Biochemical Recurrence After Radical Prostatectomy in Prostate Cancer Patients Diagnosed with Magnetic Resonance Imaging–targeted Biopsy

Cited by 38 publications

References 30 publications

MRI utility in predicting extraprostatic extension of prostate cancer and biochemical recurrence after radical prostatectomy

MRI utility in predicting extraprostatic extension of prostate cancer and biochemical recurrence after radical prostatectomy

The Prognostic Association of Prostate MRI PI-RADS™ v2 Assessment Category and Risk of Biochemical Recurrence after Definitive Local Therapy for Prostate Cancer: A Systematic Review and Meta-Analysis

Combined Systematic and MRI-US Fusion Prostate Biopsy Has the Highest Grading Accuracy When Compared to Final Pathology

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