Quantification of Gleason Pattern 4 at MRI-Guided Biopsy to Predict Adverse Pathology at Radical Prostatectomy in Intermediate-Risk Prostate Cancer Patients
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. MRI-Guided Biopsy
2.2. Biopsy Pathology Reporting
2.3. Gleason Pattern 4 Quantification Methods
2.4. Radical Prostatectomy and Adverse Pathology
2.5. Outcome Measurements and Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic | All Patients (n = 123) | ||
---|---|---|---|
Median age, years (IQR) | 66 (62–71) | ||
Median PSA, ng/mL (IQR) | 7.4 (5.7–9.4) | ||
Maximum PIRADS category | |||
2 | 4 (3.3%) | ||
3 | 11 (8.9%) | ||
4 | 71 (57.7%) | ||
5 | 37 (30.1%) | ||
Median PV, mL (IQR) | 34 (29–47) | ||
Median PSAD, ng/mL2 (IQR) | 0.21 (0.13–0.28) | ||
Type of MRI-guided biopsy | |||
cognitive | 61 (49.6%) | ||
software fusion | 62 (50.4%) | ||
Number of targeted lesions | |||
1 | 73 (59.3%) | ||
2 | 38 (30.9%) | ||
≥3 | 12 (9.8%) | ||
Median length of cores, mm (IQR) | |||
overall | 132 (99–172) | ||
targeted | 64 (44–98) | ||
systematic a | 64 (39–82) | ||
Grade group at biopsy b | |||
2 | 97 (78.9%) | ||
3 | 26 (21.1%) | ||
GP4 amount, median (IQR) | |||
GP4%cores c | OB | 5.8% (3.3–10.6%) | |
TB | 10.0% (5.0–20.0%) | ||
SB | 0.0% (0.0–1.2%) | ||
WS | 15.0% (8.0–25.0%) | ||
GP4%cancer c | OB | 30.9% (20.1–43.7%) | |
TB | 33.3% (22.2–50.2%) | ||
SB | 7.1% (0.0–32.1%) | ||
WS | 36.4% (26.5–54.4%) | ||
GP4mm c | OB | 7.0 (3.9–14.5) | |
TB | 6.9 (4.0–12.2) | ||
SB | 2.2 (1.5–3.3) | ||
WS | 6.5 (3.6–12.0) | ||
PV × GP4, mL c | 2.51 (1.11–3.61) | ||
Cribriform pattern present | 59 (48.0) | ||
Grade group at RP | |||
1 | 5 (4.1%) | ||
2 | 59 (48.0%) | ||
3 | 46 (37.4%) | ||
4 | 13 (10.6%) | ||
5 | 0 (0.0%) | ||
Tumor stage at RP | |||
T2 | 95 (77.2%) | ||
T3a | 22 (17.9%) | ||
T3b | 6 (4.9%) | ||
pN1 | 4 (3.3%) | ||
Adverse pathology | 39 (31.7%) |
Characteristic | AP (n = 39) | No–AP (n = 84) | p-Value | ||
---|---|---|---|---|---|
Median age, years (IQR) | 67 (64–72) | 65 (60–71) | 0.158 | ||
Median PSA, ng/mL (IQR) | 8.9 (6.2–10.4) | 7.1 (5.1–8.9) | 0.029 | ||
PIRADS category 5 | 13 (33.3%) | 24 (28.6%) | 0.745 | ||
Median PV, mL (IQR) | 38 (30–52) | 34 (28–42) | 0.078 | ||
Median PSAD, ng/mL2 (IQR) | 0.21 (0.15–0.28) | 0.21 (0.13–0.28) | 0.587 | ||
Grade group 3 (vs 2) a | 11 (28.2%) | 15 (17.9%) | 0.191 | ||
GP4 amount, median (IQR) | |||||
GP4%cores b | OB | 8.7% (5.1–12.1%) | 5.2% (3.0–9.3%) | 0.009 | |
TB | 13.2% (6.4–22.4%) | 10.0% (5.0–20.0%) | 0.248 | ||
SB | 0.0% (0.0–2.4%) | 0.0% (0.0–0.0%) | 0.031 | ||
WS | 20.0% (10.0–30.0%) | 11.5% (6.0–20.0%) | 0.027 | ||
GP4%cancer b | OB | 33.3% (22.1–52.8%) | 30.3% (20.0–40.0%) | 0.129 | |
TB | 40.0% (25.8–58.8%) | 33.3% (20.4–42.9%) | 0.062 | ||
SB | 22.5% (0.0–34.8%) | 0.0% (0.0–26.1%) | 0.089 | ||
WS | 40.0% (33.3–61.9%) | 34.3% (22.2–44.6%) | 0.054 | ||
GP4mm b | OB | 9.9 (5.1–19.5) | 6.5 (3.9–10.9) | 0.033 | |
TB | 9.0 (4.9–17.9) | 6.4 (4.0–10.0) | 0.047 | ||
SB | 2.3 (1.2–3.0) | 1.8 (1.6–3.7) | 0.799 | ||
WS | 8.7 (4.8–14.7) | 6.0 (3.3–9.7) | 0.044 | ||
PV × GP4, mL | 2.95 (1.82–4.14) | 1.85 (0.94–3.27) | 0.003 | ||
Cribriform pattern present | 19 (50.0%) | 40 (47.6%) | 0.962 |
Variable | ROC AUC (95% CI) | Optimal Threshold | NPV, % (95% CI) |
---|---|---|---|
GP4%cores, OB | 0.65 (0.56–0.74) | 6.4% | 80.3 (70.7–89.9) |
GP4%cores, SB | 0.60 (0.50–0.69) | – a | – a |
GP4%cores, WS | 0.62 (0.53–0.71) | 12.0% | 79.2 (68.3–90.2) |
GP4 mm, OB | 0.62 (0.53–0.71) | 11.3 mm | 76.2 (67.1–85.3) |
GP4 mm, TB | 0.62 (0.52–0.71) | 9.9 mm | 76.9 (67.6–86.3) |
GP4 mm, WS | 0.61 (0.52–0.70) | 8.1 mm | 75.7 (65.9–85.5) |
PV × GP4 | 0.67 (0.58–0.75) | 2.55 mL | 82.8 (73.6–92.1) |
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Kamecki, H.; Mielczarek, Ł.; Szempliński, S.; Dębowska, M.; Rajwa, P.; Baboudjian, M.; Klemm, J.; Rivas, J.G.; Modzelewska, E.; Tayara, O.; et al. Quantification of Gleason Pattern 4 at MRI-Guided Biopsy to Predict Adverse Pathology at Radical Prostatectomy in Intermediate-Risk Prostate Cancer Patients. Cancers 2023, 15, 5462. https://doi.org/10.3390/cancers15225462
Kamecki H, Mielczarek Ł, Szempliński S, Dębowska M, Rajwa P, Baboudjian M, Klemm J, Rivas JG, Modzelewska E, Tayara O, et al. Quantification of Gleason Pattern 4 at MRI-Guided Biopsy to Predict Adverse Pathology at Radical Prostatectomy in Intermediate-Risk Prostate Cancer Patients. Cancers. 2023; 15(22):5462. https://doi.org/10.3390/cancers15225462
Chicago/Turabian StyleKamecki, Hubert, Łukasz Mielczarek, Stanisław Szempliński, Małgorzata Dębowska, Paweł Rajwa, Michael Baboudjian, Jakob Klemm, Juan Gómez Rivas, Elza Modzelewska, Omar Tayara, and et al. 2023. "Quantification of Gleason Pattern 4 at MRI-Guided Biopsy to Predict Adverse Pathology at Radical Prostatectomy in Intermediate-Risk Prostate Cancer Patients" Cancers 15, no. 22: 5462. https://doi.org/10.3390/cancers15225462
APA StyleKamecki, H., Mielczarek, Ł., Szempliński, S., Dębowska, M., Rajwa, P., Baboudjian, M., Klemm, J., Rivas, J. G., Modzelewska, E., Tayara, O., Malewski, W., Szostek, P., Poletajew, S., Kryst, P., Sosnowski, R., & Nyk, Ł. (2023). Quantification of Gleason Pattern 4 at MRI-Guided Biopsy to Predict Adverse Pathology at Radical Prostatectomy in Intermediate-Risk Prostate Cancer Patients. Cancers, 15(22), 5462. https://doi.org/10.3390/cancers15225462