An updated model for predicting side-specific extraprostatic extension in the era of MRI-targeted biopsy.

Details

Serval ID
serval:BIB_00422DF903AC
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
An updated model for predicting side-specific extraprostatic extension in the era of MRI-targeted biopsy.
Journal
Prostate cancer and prostatic diseases
Author(s)
Martini A., Wever L., Soeterik TFW, Rakauskas A., Fankhauser C.D., Grogg J.B., Checcucci E., Amparore D., Haiquel L., Rodriguez-Sanchez L., Ploussard G., Qiang P., Affentranger A., Marquis A., Marra G., Ettala O., Zattoni F., Falagario U.G., De Angelis M., Kesch C., Apfelbeck M., Al-Hammouri T., Kretschmer A., Kasivisvanathan V., Preisser F., Lefebvre E., Olivier J., Radtke J.P., Carrieri G., Moro F.D., Boström P., Jambor I., Gontero P., Chiu P.K., John H., Macek P., Porpiglia F., Hermanns T., van den Bergh RCN, van Basten J.A., Gandaglia G., Valerio M.
Working group(s)
Young Academic Urologists working group on Prostate Cancer of the European Association of Urology
ISSN
1476-5608 (Electronic)
ISSN-L
1365-7852
Publication state
Published
Issued date
09/2024
Peer-reviewed
Oui
Volume
27
Number
3
Pages
520-524
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Abstract
Accurate prediction of extraprostatic extension (EPE) is pivotal for surgical planning. Herein, we aimed to provide an updated model for predicting EPE among patients diagnosed with MRI-targeted biopsy.
We analyzed a multi-institutional dataset of men with clinically localized prostate cancer diagnosed by MRI-targeted biopsy and subsequently underwent prostatectomy. To develop a side-specific predictive model, we considered the prostatic lobes separately. A multivariable logistic regression analysis was fitted to predict side-specific EPE. The decision curve analysis was used to evaluate the net clinical benefit. Finally, a regression tree was employed to identify three risk categories to assist urologists in selecting candidates for nerve-sparing, incremental nerve sparing and non-nerve-sparing surgery.
Overall, data from 3169 hemi-prostates were considered, after the exclusion of prostatic lobes with no biopsy-documented tumor. EPE was present on final pathology in 1,094 (34%) cases. Among these, MRI was able to predict EPE correctly in 568 (52%) cases. A model including PSA, maximum diameter of the index lesion, presence of EPE on MRI, highest ISUP grade in the ipsilateral hemi-prostate, and percentage of positive cores in the ipsilateral hemi-prostate achieved an AUC of 81% after internal validation. Overall, 566, 577, and 2,026 observations fell in the low-, intermediate- and high-risk groups for EPE, as identified by the regression tree. The EPE rate across the groups was: 5.1%, 14.9%, and 48% for the low-, intermediate- and high-risk group, respectively.
In this study we present an update of the first side-specific MRI-based nomogram for the prediction of extraprostatic extension together with updated risk categories to help clinicians in deciding on the best approach to nerve-preservation.
Keywords
Humans, Male, Prostatic Neoplasms/pathology, Prostatic Neoplasms/diagnostic imaging, Prostatic Neoplasms/surgery, Magnetic Resonance Imaging/methods, Image-Guided Biopsy/methods, Middle Aged, Aged, Prostatectomy/methods, Prostate/pathology, Prostate/diagnostic imaging, Prostate/surgery, Nomograms, Prognosis, Retrospective Studies, Neoplasm Grading
Pubmed
Web of science
Create date
12/01/2024 12:52
Last modification date
20/08/2024 7:23
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