Concordance between Preoperative mpMRI and Pathological Stage and Its Influence on Nerve-Sparing Surgery in Patients with High-Risk Prostate Cancer.

Autor: Humke C; Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60590 Frankfurt, Germany., Hoeh B; Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60590 Frankfurt, Germany.; Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H4A 3J1, Canada., Preisser F; Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60590 Frankfurt, Germany., Wenzel M; Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60590 Frankfurt, Germany., Welte MN; Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60590 Frankfurt, Germany., Theissen L; Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60590 Frankfurt, Germany., Bodelle B; Department of Radiology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60590 Frankfurt, Germany., Koellermann J; Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, 60590 Frankfurt, Germany., Steuber T; Martini-Clinic Prostate Cancer Center, University Hospital Hamburg-Eppendorf, 20251 Hamburg, Germany., Haese A; Martini-Clinic Prostate Cancer Center, University Hospital Hamburg-Eppendorf, 20251 Hamburg, Germany., Roos F; Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60590 Frankfurt, Germany., Kluth LA; Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60590 Frankfurt, Germany., Becker A; Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60590 Frankfurt, Germany., Chun FKH; Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60590 Frankfurt, Germany., Mandel P; Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60590 Frankfurt, Germany.
Jazyk: angličtina
Zdroj: Current oncology (Toronto, Ont.) [Curr Oncol] 2022 Mar 28; Vol. 29 (4), pp. 2385-2394. Date of Electronic Publication: 2022 Mar 28.
DOI: 10.3390/curroncol29040193
Abstrakt: Background: We aimed to determine the concordance between the radiologic stage (rT), using multiparametric magnetic resonance imaging (mpMRI), and pathologic stage (pT) in patients with high-risk prostate cancer and its influence on nerve-sparing surgery compared to the use of the intraoperative frozen section technique (IFST).
Methods: The concordance between rT and pT and the rates of nerve-sparing surgery and positive surgical margin were assessed for patients with high-risk prostate cancer who underwent radical prostatectomy.
Results: The concordance between the rT and pT stages was shown in 66.4% ( n = 77) of patients with clinical high-risk prostate cancer. The detection of patients with extraprostatic disease (≥pT3) by preoperative mpMRI showed a sensitivity, negative predictive value and accuracy of 65.1%, 51.7% and 67.5%. In addition to the suspicion of extraprostatic disease in mpMRI (≥rT3), 84.5% ( n = 56) of patients with ≥rT3 underwent primary nerve-sparing surgery with IFST, resulting in 94.7% ( n = 54) of men with at least unilateral nerve-sparing surgery after secondary resection with a positive surgical margin rate related to an IFST of 1.8% ( n = 1).
Conclusion: Patients with rT3 should not be immediately excluded from nerve-sparing surgery, as by using IFST some of these patients can safely undergo nerve-sparing surgery.
Databáze: MEDLINE
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