| Autor: |
Telecan, T., Andraș, I., Kadula, P. A., Posea, A., Căta, E. D., Medan, Ș. A., Giurgiu, L., Tișe, A. I., Platon, M., Bungărdean, C., Coman, I., Stanca, D. V., Crișan, N. |
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| Zdroj: |
Romanian Journal of Urology; 2021, Vol. 20 Issue 3, p24-29, 6p |
| Abstrakt: |
Introduction and Objectives. Prostate cancer is staged based upon digital rectal examination findings, with average accuracy. As such, special magnetic resonance imaging (MRI) protocols have been implemented and particularized for identifying prostate cancer (PCa), reaching a concordance of 87% between preoperatory prediction and pathological staging. The aim was to determine the accuracy of mpMRI in terms of staging, as well as serving as a preoperative planning tool, by analyzing all cases who underwent mpMRI prior to radical prostatectomy in our department, in the past 5 years. Materials and Methods. A total number of 177 patients were included, from 2017 to 2022. All patients had preoperative mpMRI that certified a lesion with a PIRADS score ≥ 3 and had performed systematic or targeted prostate biopsy confirming the malignancy. 2D/3D laparoscopic radical prostatectomy was performed in all cases. Results. The preoperative mpMRI staged 91.08% of the patients with prostate-confined disease, whereas 8.97% were suspected of harboring extracapsular extension or seminal vesicle invasion. Comparing the mpMRI prediction to the final pathological staging, we observed a 75% concordance rate. Upstaging from cT2 at MRI to pT3 on RP specimen was observed in 21.15% of the patients. The presence of a PIRADS 5 lesion has an OR of 1.33 for upstaging (p = 0.48) and OR 2.93 for positive surgical margins (p = 0.05). The upstaged patients had a significantly higher average PSA value (12.46 versus 8.26, p = 0.001). Conclusions. mpMRI performed before radical prostatectomy has a high local staging accuracy and allows for a tailored surgical planning. The presence of a PIRADS 5 lesion and a PSA value greater than 10 ng/ml were associated with a higher risk of upstaging at final pathology. [ABSTRACT FROM AUTHOR] |
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