Mp62-11 Pi-rads Score Predicts Extraprostatic Extension and Lymph Node Metastasis in Men Undergoing Radical Prostatectomy
Year: 2020
Type: article
Study design: Observational Study
Abstract: You have accessJournal of UrologyProstate Cancer: Staging I (MP62)1 Apr 2020MP62-11 PI-RADS SCORE PREDICTS EXTRAPROSTATIC EXTENSION AND LYMPH NODE METASTASIS IN MEN UNDERGOING RADICAL PROSTATECTOMY Zachary Feuer*, Ezequiel Becher, Xiaosong Meng, Richard Huang, James Wysock, William C. Huang, Fang-Ming Deng, Andrew B. Rosenkrantz, and Samir Taneja Zachary Feuer*Zachary Feuer* More articles by this author , Ezequiel BecherEzequiel Becher More articles by this author , Xiaosong MengXiaosong Meng More articles by this author , Richard HuangRichard Huang More articles by this author , James WysockJames Wysock More articles by this author , William C. HuangWilliam C. Huang More articles by this author , Fang-Ming DengFang-Ming Deng More articles by this author , Andrew B. RosenkrantzAndrew B. Rosenkrantz More articles by this author , and Samir TanejaSamir Taneja More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000937.011AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The AUA recently released an updated policy statement endorsing the use of multiparametric MRI in the diagnosis of prostate cancer (PCa), but stating there was inadequate data to support its use in staging. In this study, we assessed the independent ability of PIRADS score extraprostatic extension (EPE) and the presence of lymph node metastasis (LNM) in men undergoing robotic-assisted laparoscopic radical prostatectomy (RALP). METHODS: Clinicopathologic data from 468 men between 7/2012 and 3/2019 who underwent RALP following prostate MRI were extracted from an IRB-approved prospective biopsy (bx) database. 442 men with pre-operative MRI, reported PI-RADS score, and no prior treatment were included. PI-RADS score was assessed as a predictor of EPE defined as ≥pT3a, or presence of LNM on post-operative pathology using univariate and multivariate analysis (MVA) using logistic regression with odds ratios (OR). RESULTS: Median age was 65.7 at time of RALP (IQR 60.5-70.0) and median pre-bx PSA was 6.50 (IQR 4.55-8.98). In univariate analysis, PI-RADS 4 and 5 regions of interest (ROI) were associated with increased odds of EPE, OR 2.12 (p=0.026) and OR 9.65 (p <0.0001), respectively. There were 21 (4.7%) men with LNM identified at time of RALP. Of these, 14 men had PIRADS 5 ROIs, which was predictive of LNM (OR 9.53, p=0.03). In the MVA, PIRADS 5 ROIs remained a predictor of EPE (OR 3.78, p=0.001). Other factors predictive of EPE included GGG ≥3 on MRI-targeted bx and maximum cancer core length >10mm on bx (Table 2). Only pre-bx PSA >20 ng/mL was associated with LNM (OR 9.05, p=0.002) on MVA. CONCLUSIONS: PI-RADS 4/5 ROIs on prostate MRI independently predict ECE at time of RALP. A PI-RADS 5 ROI is also predictive of LNM, and remains predictive of EPE in MVA. These findings may be used to counsel patients regarding risk of adverse pathology prior to bx or intervention in the era of expanding utilization of pre-bx MRI. Further investigation with a larger cohort of patients with LNM is warranted to characterize the relationship between PI-RADS and LNM. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e949-e950 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Zachary Feuer* More articles by this author Ezequiel Becher More articles by this author Xiaosong Meng More articles by this author Richard Huang More articles by this author James Wysock More articles by this author William C. Huang More articles by this author Fang-Ming Deng More articles by this author Andrew B. Rosenkrantz More articles by this author Samir Taneja More articles by this author Expand All Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Authors: Zachary Feuer*, Ezequiel Becher, Xiaosong Meng, Richard Huang, James Wysock, William C. Huang, Fang-Ming Deng, Andrew B. Rosenkrantz, Samir Taneja
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W3023552331