MRI-Detectability of Clinically Significant Prostate Cancer Relates to Oncologic Outcomes After Prostatectomy.
MRI-Detectability of Clinically Significant Prostate Cancer Relates to Oncologic Outcomes After Prostatectomy.
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临床上显着的前列腺癌的MRI检测性与前列腺切除术后的肿瘤学结局有关。
DOI：
10.1016/j.clgc.2022.04.001
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发表时间：
2022-08
影响因子：
3.2
通讯作者：
中科院分区：
文献类型：
--
作者：
磁共振成像（MRI）错过了一部分由组织病理学标准定义的“临床显著”前列腺癌（csPC）。本研究的目的是研究MRI可检测和MRI隐匿csPC之间的长期肿瘤学结局是否存在差异。回顾性分析了1,449例患者的腰椎切除术前MRI和腰椎切除术标本的csPC（即，≥2级组或前列腺外扩散）。根据前列腺成像报告和数据系统，将T2加权MRI分为MRI隐匿性（1、2类）、MRI可疑（3类）和MRI可检测（4、5类）。生化复发（BCR）、转移性疾病和癌症特异性死亡率的累积发生率，采用竞争风险模型估计。存活者的中位随访时间为11.0年（IQR：8.9-13.1）。在188例（13%）病例中，csPC为MRI隐匿性，435例（30%）MRI不明确，826例（57%）csPC为MRI可检测。MRI隐匿性病例的15年累积BCR发生率[95% CI]为8.3% [2.2，19.5]，MRI可疑病例为17.4% [11.1，24.8]，MRI可检测病例为43.3% [38.7，47.8]（p<0.001）。MRI隐匿、MRI可疑和MRI可检测病例的转移累积发生率分别为0.61% [0.06，3.1]、3.5% [1.5，6.9]和19.6% [15.4，24.2]（p<0.001）。在MRI隐匿性csPC患者中未观察到前列腺癌死亡，而MRI可疑和MRI可检测癌症患者分别估计为1.9% [0.54，4.9]和7.1%[4.5，10.6]（p<0.001）。MRI隐匿性和MRI可检测病变的csPC直肠切除术后的肿瘤结局不同。仅根据组织病理学替代物判断前列腺MRI阴性的临床意义可能会产生误导。
Magnetic resonance imaging (MRI) misses a proportion of “clinically significant” prostate cancers (csPC) as defined by histopathology criteria. The aim of this study was to study whether long-term oncologic outcomes differ between MRI-detectable and MRI-occult csPC. Retrospective analysis of 1,449 patients with pre-prostatectomy MRI and csPC on prostatectomy specimens (i.e., Grade group ≥2 or extraprostatic spread) between 2001–2006. T2-weighted MRIs were classified according to the Prostate Imaging Reporting and Data System into MRI-occult (categories 1, 2), MRI-equivocal (category 3), and MRI-detectable (categories 4, 5). Cumulative incidence of biochemical recurrence (BCR), metastatic disease, and cancer-specific mortality, estimated with competing risk models. The median follow-up in survivors was 11.0 years (IQR: 8.9–13.1). In 188 (13%) cases, csPC was MRI-occult, 435 (30%) MRIs were equivocal, and 826 (57%) csPC were MRI-detectable. The 15-year cumulative incidence [95% CI] of BCR was 8.3% [2.2, 19.5] for MRI-occult cases, 17.4% [11.1, 24.8] for MRI-equivocal cases, and 43.3% [38.7, 47.8] for MRI-detectable cases (p<0.001). The cumulative incidences of metastases were 0.61% [0.06, 3.1], 3.5% [1.5, 6.9], and 19.6% [15.4, 24.2] for MRI-occult, MRI-equivocal, and MRI-detectable cases, respectively (p<0.001). There were no deaths from prostate cancer observed in patients with MRI-occult csPC, compared to an estimated 1.9% [0.54, 4.9], and 7.1 % [4.5, 10.6] for patients with MRI-equivocal and MRI-detectable cancer, respectively (p<0.001). Oncologic outcomes after prostatectomy for csPC differ between MRI-occult and MRI-detectable lesions. Judging the clinical significance of a negative prostate MRI based on histopathologic surrogates alone might be misleading.
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影响因子：
23.4
作者：
Cohen, Michael S.;Hanley, Robert S.;Libertino, John A.
通讯作者：
Libertino, John A.
影响因子：
5.9
作者：
Akin, Oguz;Riedl, Christopher C.;Hricak, Hedvig
通讯作者：
Hricak, Hedvig
DOI：
10.1056/nejmoa1113162
发表时间：
2012-07-19
期刊：
The New England journal of medicine
影响因子：
--
作者：
Wilt TJ;Brawer MK;Jones KM;Barry MJ;Aronson WJ;Fox S;Gingrich JR;Wei JT;Gilhooly P;Grob BM;Nsouli I;Iyer P;Cartagena R;Snider G;Roehrborn C;Sharifi R;Blank W;Pandya P;Andriole GL;Culkin D;Wheeler T;Prostate Cancer Intervention versus Observation Trial (PIVOT) Study Group
通讯作者：
Prostate Cancer Intervention versus Observation Trial (PIVOT) Study Group
DOI：
10.2214/ajr.14.13373
发表时间：
2015-04
期刊：
AJR. American journal of roentgenology
影响因子：
--
作者：
Tan CH;Hobbs BP;Wei W;Kundra V
通讯作者：
Kundra V
影响因子：
3.2
作者：
Capogrosso, Paolo;Vertosick, Emily A.;Eastham, James A.
通讯作者：
Eastham, James A.