MRI Characteristics Accurately Predict Biochemical Recurrence after Radical Prostatectomy
Abstract
:1. Introduction
2. Experimental Section
2.1. Patient Selection, Assessment, Treatment, and Follow-Up
2.2. MRI Protocol
2.3. BCR
2.4. Statistical Analyses
3. Results
3.1. Population Characteristics
3.2. BCR-Free Survival According to PI-RADS Score
3.3. BCR-Free Survival According to ECE on MRI
3.4. BCR-Free Survival According to Number of MRI Lesions
3.5. BCR-Free Survival According to Maximal Lesion Diameter
3.6. BCR-Free Survival According to ISUP Grade Group in Targeted Biopsy
3.7. MRI Imaging-Based Risk Classification
- Low risk, which includes no ECE on MRI, ISUP grade group 1–2 in TB, and PI-RADS < 5
- Intermediate risk, which includes PI-RADS = 5 or ISUP grade group 3 in TB with no ECE MRI
- High-risk, which includes ECE on MRI or ISUP grade group 4–5 in TB (regardless of the PI-RADS)
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Overall | |
---|---|
n = 521 | |
Age (years): | |
Mean | 64.86 |
Median (Range) | 65.70 (46.80–77.90) |
PSA (ng/mL): | |
Mean | 10.26 |
Median (Range) | 8 (0.65–69) |
PSAD: | |
Mean | 0.24 |
Median (Range) | 0.18 (0.03–1.28) |
Clinical stage: | |
T1 | 342 (65.6%) |
T2 | 168 (32.2%) |
T3 | 11 (2.1%) |
PI-RADS | |
3 | 103 (19.8%) |
4 | 260 (49.9%) |
5 | 158 (30.3%) |
No of MRI lesions | |
1 | 373 (71.6%) |
2 | 121 (23.2%) |
≥3 | 27 (5.2%) |
MRI Maximal lesion diameter (mm): | |
<10 | 211 (40.5%) |
10–15 | 130 (25%) |
>15 | 91 (17.5%) |
Missing | 89 (17.0%) |
MRI stage: | |
No ECE on MRI | 436 (83.7%) |
ECE on MRI | 83 (15.9%) |
Missing | 2 (0.4%) |
ISUP grade group TB | |
Negative biopsies | 57 (11.0%) |
1 | 60 (11.5%) |
2 | 235 (45.1%) |
3 | 108 (20.7%) |
4–5 | 61 (11.7%) |
ISUP grade group TB | |
Negative biopsies | 82 (15.7%) |
1 | 134 (25.7%) |
2 | 203 (39.0%) |
3 | 64 (12.3%) |
4–5 | 38 (7.3%) |
Pathological stage pT: | |
pT2 | 245 (47.0%) |
pT3a | 185 (35.5%) |
pT3b | 91 (17.5%) |
Regional lymph nodes pN | |
pNx | 68 (13.1%) |
pN0 | 403 (77.4%) |
pN1 | 50 (9.6%) |
ISUP grade group RP: | |
1 | 16 (3.1%) |
2 | 269 (51.6%) |
3 | 189 (36.3%) |
4–5 | 47 (9.0%) |
Margin: | |
Negative | 406 (77.9%) |
Positive | 115 (22.1%) |
Biochemical recurrence: | |
YES | 49 (9.4%) |
NO | 465 (89.3%) |
Missing | 7 (1.3%) |
Overall | pT Stage in RP | pN1 | ISUP Grade Group in RP | Margin R1 | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
pT2 245 (47.0%) | pT3a 185 (35.5%) | pT3b–pT4 91 (17.5%) | 50 (9.6%) | 1 16 (3.1%) | 2 269 (51.6%) | 3 189 (36.3%) | 4–5 47 (9.0%) | 115 (22.1%) | ||||||
PIRADS | p = 0.013 | p < 0.001 | p = 0.001 | p = 0.053 | ||||||||||
3 | (n = 103) | 53 (51.5%) | 35 (34.0%) | 15 (14.6%) | 2 (1.9%) | 5 (4.9%) | 57 (55.3%) | 34 (33.0%) | 7 (6.8%) | 28 (27.2%) | ||||
4 | (n = 260) | 135 (51.9%) | 87 (33.5%) | 38 (14.6%) | 22 (8.5%) | 6 (2.3%) | 155 (59.6%) | 78 (30.0%) | 21 (8.0%) | 46 (17.7%) | ||||
5 | (n = 158) | 57 (36.1%) | 63 (39.9%) | 38 (24.1%) | 26 (16.5%) | 5 (3.2%) | 57 (36.1%) | 77 (48.7%) | 19 (12.0%) | 41 (25.9%) | ||||
ECE on MRI | p < 0.001 | p < 0.001 | p <0.001 | p < 0.001 | ||||||||||
No | (n = 436) | 232 (53.2%) | 152 (34.9%) | 52 (11.9%) | 25 (5.7%) | 16 (3.7%) | 243 (55.7%) | 149 (34.2%) | 28 (6.4%) | 85 (19.5%) | ||||
Yes | (n = 83) | 11 (13.2%) | 33 (39.8%) | 39 (47.0%) | 25 (30.1%) | 0 (0.0%) | 25 (30.1%) | 39 (47.0%) | 19 (22.9%) | 30 (36.1%) | ||||
No of MRI lesions | p < 0.001 | p = 0.269 | p = 0.216 | p = 0.262 | ||||||||||
1 | (n = 373) | 174 (46.6%) | 132 (35.4%) | 67 (18.0%) | 34 (9.1%) | 11 (2.9%) | 191 (51.2%) | 138 (37.0%) | 33 (8.9%) | 87 (23.3%) | ||||
2 | (n = 121) | 60 (49.6%) | 41 (33.9%) | 20 (16.5%) | 14 (11.6%) | 4 (3.3%) | 59 (48.8%) | 44 (36.4%) | 14 (11.6%) | 25 (20.7%) | ||||
≥3 | (n = 27) | 11 (47.0%) | 12 (44.4%) | 4 (14.8%) | 2 (7.4%) | 1 (3.7%) | 19 (70.4%) | 7 (25.9%) | 0 (0.0%) | 3 (11.1%) | ||||
MRI Maximal lesion diameter (mm): | p = 0.003 | p = 0.070 | p = 0.045 | p = 0.125 | ||||||||||
<10 | (n = 211) | 109 (51.7%) | 72 (34.1%) | 30 (14.2%) | 14 (6.6%) | 5 (2.4%) | 120 (56.9%) | 65 (30.8%) | 21 (10.0%) | 46 (21.8%) | ||||
10–15 | (n = 130) | 60 (46.2%) | 44 (33.8%) | 26 (20.0%) | 16 (12.3%) | 4 (3.1%) | 59 (45.4%) | 56 (43.1%) | 11 (8.5%) | 25 (19.2%) | ||||
>15 | (n = 91) | 28 (45.6%) | 35 (38.5%) | 28 (30.8%) | 16 (17.6%) | 2 (2.2%) | 35 (38.5%) | 40 (44.0%) | 14 (15.4%) | 28 (30.8%) | ||||
ISUP grade group in TB | p < 0.001 | p < 0.001 | p < 0.001 | p = 0.001 | ||||||||||
1 | (n = 60) | 33 (55.0%) | 19 (31.7%) | 8 (13.3%) | 1 (1.7%) | 3 (33%) | 44 (73.3%) | 2 (3.3%) | 3 (5.0%) | 12 (20%) | ||||
2 | (n = 235) | 123 (35.2%) | 82 (34.9%) | 30 (12.8%) | 12 (5.1%) | 4 (1.7%) | 152 (64.7%) | 72 (30.6%) | 7 (3.0%) | 42 (17.9%) | ||||
3 | (n = 108) | 38 (35.2%) | 41 (38.0%) | 29 (26.9%) | 19 (17.6%) | 2 (1.9%) | 29 (26.9%) | 69 (63.9%) | 8 (7.5%) | 27 (25%) | ||||
4–5 | (n = 61) | 14 (23.0%) | 24 (39.3%) | 23 (37.7%) | 15 (24.6%) | 0 (0.0%) | 6 (9.8%) | 29 (47.5%) | 26 (42.6%) | 26 (42.6%) |
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Manceau, C.; Beauval, J.-B.; Lesourd, M.; Almeras, C.; Aziza, R.; Gautier, J.-R.; Loison, G.; Salin, A.; Tollon, C.; Soulié, M.; et al. MRI Characteristics Accurately Predict Biochemical Recurrence after Radical Prostatectomy. J. Clin. Med. 2020, 9, 3841. https://doi.org/10.3390/jcm9123841
Manceau C, Beauval J-B, Lesourd M, Almeras C, Aziza R, Gautier J-R, Loison G, Salin A, Tollon C, Soulié M, et al. MRI Characteristics Accurately Predict Biochemical Recurrence after Radical Prostatectomy. Journal of Clinical Medicine. 2020; 9(12):3841. https://doi.org/10.3390/jcm9123841
Chicago/Turabian StyleManceau, Cécile, Jean-Baptiste Beauval, Marine Lesourd, Christophe Almeras, Richard Aziza, Jean-Romain Gautier, Guillaume Loison, Ambroise Salin, Christophe Tollon, Michel Soulié, and et al. 2020. "MRI Characteristics Accurately Predict Biochemical Recurrence after Radical Prostatectomy" Journal of Clinical Medicine 9, no. 12: 3841. https://doi.org/10.3390/jcm9123841