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MP09-02 ADDED VALUE OF MPMRI, MRI-TARGETED AND SYSTEMATIC BIOPSY IN THE PREDICTION OF ADVERSE PATHOLOGIC FEATURES IN CONTEMPORARY PROSTATE CANCER PATIENTS UNDERGOING RADICAL PROSTATECTOMY

2019; Lippincott Williams & Wilkins; Volume: 201; Issue: Supplement 4 Linguagem: Inglês

10.1097/01.ju.0000555126.00531.78

1527-3792

Giorgio Gandaglia, Guillaume Ploussard, Massimo Valério, Agostino Mattei, Cristian Fiori, Nicola Fossati, Armando Stabile, Jean‐Baptiste Beauval, Bernard Malavaud, M. Roumiguié, Daniele Robesti, Paolo Dell’Oglio, Marco Moschini, Stefania Zamboni, Arnas Rakauskas, Federico Dehò, Andrea Gallina, Francesco De Cobelli, F. Porpiglia, Francesco Montorsi, Alberto Briganti,

Genetic factors in colorectal cancer

You have accessJournal of UrologyProstate Cancer: Staging I (MP09)1 Apr 2019MP09-02 ADDED VALUE OF MPMRI, MRI-TARGETED AND SYSTEMATIC BIOPSY IN THE PREDICTION OF ADVERSE PATHOLOGIC FEATURES IN CONTEMPORARY PROSTATE CANCER PATIENTS UNDERGOING RADICAL PROSTATECTOMY Giorgio Gandaglia*, Guillaume Ploussard, Massimo Valerio, Agostino Mattei, Cristian Fiori, Nicola Fossati, Armando Stabile, Jean-Baptiste Beauval, Bernard Malavaud, Mathieu Roumiguié, Daniele Robesti, Paolo Dell'Oglio, Marco Moschini, Stefania Zamboni, Arnas Rakauskas, Federico Dehò, Andrea Gallina, Francesco De Cobelli, Francesco Porpiglia, Francesco Montorsi, and Alberto Briganti Giorgio Gandaglia*Giorgio Gandaglia* More articles by this author , Guillaume PloussardGuillaume Ploussard More articles by this author , Massimo ValerioMassimo Valerio More articles by this author , Agostino MatteiAgostino Mattei More articles by this author , Cristian FioriCristian Fiori More articles by this author , Nicola FossatiNicola Fossati More articles by this author , Armando StabileArmando Stabile More articles by this author , Jean-Baptiste BeauvalJean-Baptiste Beauval More articles by this author , Bernard MalavaudBernard Malavaud More articles by this author , Mathieu RoumiguiéMathieu Roumiguié More articles by this author , Daniele RobestiDaniele Robesti More articles by this author , Paolo Dell'OglioPaolo Dell'Oglio More articles by this author , Marco MoschiniMarco Moschini More articles by this author , Stefania ZamboniStefania Zamboni More articles by this author , Arnas RakauskasArnas Rakauskas More articles by this author , Federico DehòFederico Dehò More articles by this author , Andrea GallinaAndrea Gallina More articles by this author , Francesco De CobelliFrancesco De Cobelli More articles by this author , Francesco PorpigliaFrancesco Porpiglia More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Alberto BrigantiAlberto Briganti More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555126.00531.78AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Available models predicting extracapsular extension (ECE) and seminal vesicle invasion (SVI) in prostate cancer (PCa) patients undergoing radical prostatectomy (RP) are limited by two main factors: (i) they do not incorporate multiparametric MRI (mpMRI) and (ii) they do not account for differences in cores obtained at targeted and systematic biopsy. METHODS: Overall, 640 men with clinical stage ≤T2 who underwent MRI-targeted biopsy with concomitant systematic biopsy before RP between 2016 and 2018 were identified. The Partin tables and MSKCC nomograms estimated the probability of ECE and SVI. Their discrimination was assessed using the area under the curve (AUC) method and compared to models that included also mpMRI (ECE or SVI at mpMRI and maximum lesion diameter). Two models accounting separately for the number of positive cores from targeted and systematic biopsies were developed. The AUC compared their discrimination to models based on clinical and mpMRI variables alone and to the Partin tables and MSKCC nomograms. Decision-curve analyses (DCA) determined the net-benefit associated with the use of these models. RESULTS: Median PSA was 7.8 ng/ml. Overall, 181 (28%) patients had cT2 disease. Median mpMRI lesion diameter was 11 mm and 118 (19%) and 33 (5.2%) men had suspicious ECE and SVI. Overall, 361 (55%) and 99 (15%) patients had pathologic ECE and SVI. The AUCs of the Partin tables vs MSKCC nomograms for ECE and SVI were 61 vs 68% and 73 vs 75%. MRI parameters improved discrimination for ECE (72%) and SVI (77%). Considering separately the total number of positive cores from targeted and from systematic biopsy improved the discrimination for ECE (76%) and SVI (81%). The percentage of cores with grade group 2-5 at systematic biopsy was associated with ECE (P<0.01) and SVI (P<0.01). At DCA, models including mpMRI data and accounting for cores obtained from MRI-targeted and from systematic biopsy yield the highest net benefit compared to the other tools. A 40% cut-off to predict ECE of the novel model was associated with a higher sensitivity compared to the same cut-off of the model based on clinical parameters and mpMRI only (78 vs 73%). A 15% cut-off of the SVI risk tool was associated with a higher sensitivity (74 vs 68%). CONCLUSIONS: Combination of mpMRI data with biopsy information on targeted and systematic biopsy improves the accuracy of staging models based on clinical data alone. A correct MRI interpretation and a proper extensive prostate sampling are needed to accurately predict pathologic findings. Source of Funding: None Milan, Italy; Toulouse, France; Lausanne, Switzerland; Lucerne, Switzerland; Orbassano (Turin), Italy; Milan, Italy; Toulouse, France; Milan, Italy; Lucerne, Switzerland; Lausanne, Switzerland; Milan, Italy; Orbassano (Turin), Italy; Milan, Italy© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e107-e108 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Giorgio Gandaglia* More articles by this author Guillaume Ploussard More articles by this author Massimo Valerio More articles by this author Agostino Mattei More articles by this author Cristian Fiori More articles by this author Nicola Fossati More articles by this author Armando Stabile More articles by this author Jean-Baptiste Beauval More articles by this author Bernard Malavaud More articles by this author Mathieu Roumiguié More articles by this author Daniele Robesti More articles by this author Paolo Dell'Oglio More articles by this author Marco Moschini More articles by this author Stefania Zamboni More articles by this author Arnas Rakauskas More articles by this author Federico Dehò More articles by this author Andrea Gallina More articles by this author Francesco De Cobelli More articles by this author Francesco Porpiglia More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Expand All Advertisement PDF downloadLoading ...