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Does the Visibility of Grade Group 1 Prostate Cancer on Baseline Multiparametric Magnetic Resonance Imaging Impact Clinical Outcomes?
- Source :
-
The Journal of urology [J Urol] 2020 Dec; Vol. 204 (6), pp. 1187-1194. Date of Electronic Publication: 2020 Jun 04. - Publication Year :
- 2020
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Abstract
- Purpose: We assessed whether the visibility of Grade Group (GG) 1 prostate cancer on baseline multiparametric magnetic resonance imaging affects clinical outcomes.<br />Materials and Methods: We evaluated 454 men who underwent multiparametric magnetic resonance imaging between 2006 and 2018 with maximum GG1 prostate cancer inclusive of magnetic resonance imaging targeted biopsy. Multiparametric magnetic resonance imaging was graded as negative, equivocal or positive. Assessed outcomes were treatment-free survival, biopsy upgrade-free survival and unfavorable disease at radical prostatectomy (pT 3 or greater and/or GG3 or greater). Kaplan-Meier and multivariable Cox proportional hazard analyses were used to estimate the impact of multiparametric magnetic resonance imaging and clinicopathological variables (age, year, prostate specific antigen density and measures of tumor volume on biopsy) on outcomes.<br />Results: During followup (median 45.2 months) 61 men had disease upgraded on followup biopsy and 139 underwent definitive treatment. In men with negative, equivocal and positive baseline multiparametric magnetic resonance imaging at 5 years, treatment-free survival was 79%, 73% and 49% (p <0.0001), treatment-free survival was 89%, 82% and 70% (p=0.002), and survival without unfavorable disease at radical prostatectomy was 98%, 98% and 86% (p=0.007), respectively. At multivariable analysis positive (HR 1.93, 95% CI 1.21-3.09, p=0.006) and equivocal multiparametric magnetic resonance imaging (HR 2.02, 95% CI 1.11-3.68, p=0.02) were associated with shorter treatment-free survival, and positive multiparametric magnetic resonance imaging was a significant prognostic factor for upgrade-free survival (HR 2.03, 95% CI 1.06-3.86, p=0.03) and unfavorable disease at radical prostatectomy (HR 4.45, 95% CI 1.39-18.17, p=0.01).<br />Conclusions: Men with positive multiparametric magnetic resonance imaging and GG1 prostate cancer on magnetic resonance imaging targeted biopsy are at increased risk for intervention, upgrading and unfavorable disease at radical prostatectomy compared to those with multiparametric magnetic resonance imaging invisible GG1 prostate cancer.
- Subjects :
- Aged
Biopsy, Large-Core Needle methods
Biopsy, Large-Core Needle statistics & numerical data
Disease Progression
Disease-Free Survival
Follow-Up Studies
Humans
Image-Guided Biopsy methods
Image-Guided Biopsy statistics & numerical data
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasm Grading
Prostate pathology
Prostate surgery
Prostatic Neoplasms diagnosis
Prostatic Neoplasms pathology
Prostatic Neoplasms surgery
Retrospective Studies
Magnetic Resonance Imaging, Interventional statistics & numerical data
Multiparametric Magnetic Resonance Imaging statistics & numerical data
Prostate diagnostic imaging
Prostatectomy statistics & numerical data
Prostatic Neoplasms mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1527-3792
- Volume :
- 204
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The Journal of urology
- Publication Type :
- Academic Journal
- Accession number :
- 32496160
- Full Text :
- https://doi.org/10.1097/JU.0000000000001157