دورية أكاديمية
MRI-based PI-RADS score predicts ISUP upgrading and adverse pathology at radical prostatectomy in men with biopsy ISUP 1 prostate cancer.
| العنوان: | MRI-based PI-RADS score predicts ISUP upgrading and adverse pathology at radical prostatectomy in men with biopsy ISUP 1 prostate cancer. |
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| المؤلفون: | Dekalo S; Department of Urology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Mazliah O; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Barkai E; Department of Urology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Bar-Yosef Y; Department of Urology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Herzberg H; Department of Urology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Bashi T; Department of Urology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Fahoum I; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.; Department of Pathology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel., Barnes S; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.; Department of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel., Sofer M; Department of Urology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Yossepowitch O; Department of Urology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Keren-Paz G; Department of Urology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Mano R; Department of Urology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. |
| المصدر: | The Canadian journal of urology [Can J Urol] 2024 Aug; Vol. 31 (4), pp. 11955-11962. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: CJU Communications Country of Publication: Canada NLM ID: 9515842 Publication Model: Print Cited Medium: Internet ISSN: 1195-9479 (Print) Linking ISSN: 11959479 NLM ISO Abbreviation: Can J Urol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2005- : St. Laurent, Quebec : CJU Communications Original Publication: Baie d'Urfé, Quebec : Rodar Pub., c1994- |
| مواضيع طبية MeSH: | Prostatic Neoplasms*/pathology , Prostatic Neoplasms*/surgery , Prostatic Neoplasms*/diagnostic imaging , Prostatectomy*/methods , Multiparametric Magnetic Resonance Imaging*, Humans ; Male ; Middle Aged ; Aged ; Predictive Value of Tests ; Neoplasm Grading ; Prostate/pathology ; Prostate/diagnostic imaging ; Retrospective Studies ; Biopsy ; Neoplasm Staging ; Magnetic Resonance Imaging ; Watchful Waiting ; Risk Assessment |
| مستخلص: | Introduction: Most men diagnosed with very-low and low-risk prostate cancer are candidates for active surveillance; however, there is still a misclassification risk. We examined whether PI-RADS category 4 or 5 combined with ISUP 1 on prostate biopsy predicts upgrading and/or adverse pathology at radical prostatectomy. Materials and Methods: A total of 127 patients had ISUP 1 cancer on biopsy after multiparametric MRI (mpMRI) and then underwent radical prostatectomy. We then evaluated them for ISUP upgrading and/or adverse pathology on radical prostatectomy. Results: Eight-nine patients (70%) were diagnosed with PI-RADS 4 or 5 lesions. ISUP upgrading was significantly higher among patients with PI-RADS 4-5 lesions (84%) compared to patients with equivocal or non-suspicious mpMRI findings (26%, p < 0.001). Both PI-RADS 4-5 lesions (OR 24.3, 95% CI 7.3, 80.5, p < 0.001) and stage T2 on DRE (OR 5.9, 95% CI 1.2, 29.4, p = 0.03) were independent predictors of upgrading on multivariate logistic regression analysis. Men with PI-RADS 4-5 lesions also had significantly more extra-prostatic extension (51% vs. 3%, p < 0.001) and positive surgical margins (16% vs. 3%. p = 0.03). The only independent predictor of adverse pathology was PI-RADS 4-5 (OR 21.7, 95% CI 4.8, 99, p < 0.001). Conclusion: PI-RADS 4 or 5 lesions on mpMRI were strong independent predictors of upgrading and adverse pathology. Incorporating mpMRI findings when selecting patients for active surveillance must be further evaluated in future studies. |
| فهرسة مساهمة: | Keywords: ISUP 1; PI-RADS; magnetic resonance imaging; radical prostatectomy |
| تواريخ الأحداث: | Date Created: 20240901 Date Completed: 20240901 Latest Revision: 20240901 |
| رمز التحديث: | 20240902 |
| PMID: | 39217520 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1195-9479 |
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