Can We Improve the Preoperative Prediction of Prostate Cancer Recurrence With Multiparametric MRI?
Can We Improve the Preoperative Prediction of Prostate Cancer Recurrence With Multiparametric MRI?
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DOI：
10.1016/j.clgc.2019.03.022
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发表时间：
2019-08-01
影响因子：
3.2
通讯作者：
Eastham, James A.
中科院分区：
文献类型：
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作者：
Capogrosso, Paolo;Vertosick, Emily A.;Eastham, James A.
我们研究了将多参数磁共振成像（mpMRI）病变评分纳入前列腺癌术后生化复发的常用预测工具的临床意义。较高的mpMRI评分与较高的生化复发风险相关，尽管这种相关性在统计学上不显着，并且纳入mpMRI评分并没有改善预测模型。活检前mpMRI的价值，以改善术前风险models.Introduction：使用多参数磁共振成像（mpMRI）评估前列腺癌（PCa）在过去十年中有所增加。我们的目的是评估术前mpMRI病变评分（一个常规用于接受活检前MRI检查的男性的变量）是否改善了常用的PCa复发术前预测模型的性能。患者和方法：我们分析了2012年至2017年接受根治性前列腺切除术治疗的372例PCa患者的数据，并在手术前6个月内进行了活检前mpMRI评估。可疑癌症区域采用标准化5分制评分。使用考克斯回归评估mpMRI评分与术后生化复发风险之间的相关性。两个不同的模型进行了测试，占因素包括在Kaftan诺模图和D 'Amico风险分类。结果：总体而言，分别有53%和30%的患者在活检前mpMRI时发现病变评分为4或5。不同mpMRI的风险差异很大（5分的生化复发2年风险为29%，1-2分的生化复发2年风险为5%），调整分期、分级和前列腺特异性抗原后，mpMRI评分与较大的风险比相关：3分、4分和5分分别为1.66、1.96和2.71。然而，95%置信区间非常宽（分别为0.19-14.20、0.26-14.65和0.36-20.55），包括1。结论：我们的数据并没有显示，术前模型，通常用于评估PCa的风险，改善后，包括活检前mpMRI评分。然而，活检前mpMRl对改善术前风险模型的价值应在更大的数据集中进行研究。(C)2019爱思唯尔公司All rights reserved.
We looked at the clinical significance of including the multiparametric magnetic resonance imaging (mpMRI) lesion score in common predictive tools for biochemical recurrence after surgery for prostate cancer. Higher mpMRI scores were associated with higher risk of biochemical recurrence, although the association was not statistically significant and the predictive models were not improved by including the mpMRI score. The value of pre-biopsy mpMRI to improve preoperative risk models should be further investigated.Introduction: The use of multiparametric magnetic resonance imaging (mpMRI) to assess prostate cancer (PCa) has increased over the past decade. We aimed to assess if preoperative mpMRI lesion score, a variable routinely available for men undergoing pre-biopsy MRI, improves the performance of commonly used preoperative predictive models for PCa recurrence. Patients and Methods: We analyzed data from 372 patients with PCa treated with radical prostatectomy in 2012 to 2017 and assessed with pre-biopsy mpMRI within 6 months prior to surgery. Suspicious areas for cancer were scored on a standardized 5-point scale. Cox regression was used to assess the association between mpMRI score and the risk of postoperative biochemical recurrence. Two different models were tested accounting for factors included in the Kaftan nomogram and in the D'Amico risk-classification. Results: Overall, 53% and 30% of patients were found with a lesion scored 4 or 5 at pre-biopsy mpMRI, respectively. Risk varied widely by mpMRI (29% 2-year risk of biochemical recurrence for a score of 5 vs. 5% for a score of 1-2), and mpMRI score was associated with large hazard ratios after adjusting for stage, grade, and prostate-specific antigen: 1.66, 1.96, and 2.71 for scores 3, 4, and 5, respectively. However, 95% confidence intervals were very wide (0.19-14.20, 0.26-14.65, and 0.36-20.55, respectively) and included 1. Conclusions: Our data did not show that preoperative models, commonly used to assess PCa risk, were improved after including the pre-biopsy mpMRI score. However, the value of pre-biopsy mpMRl to improve preoperative risk models should be investigated in larger data sets. (C) 2019 Elsevier Inc. All rights reserved.