Prognostic Features of Biochemical Recurrence of Prostate Cancer Following Radical Prostatectomy Based on Multiparametric MRI and Immunohistochemistry Analysis of MRI-guided Biopsy Specimens
| Autor: | Peter L. Choyke, Peter A. Pinto, Yolanda McKinney, Inger L. Rosner, Isabell A. Sesterhenn, Shiv Srivastava, Bradford J. Wood, Albert Dobi, Denise Young, Jennifer Cullen, William Gesztes, Thomas Sanford, Jonathan Sackett, Baris Turkbey, Stephanie Harmon, Maria Merino, Sherif Mehralivand |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Biochemical recurrence
Image-Guided Biopsy Male medicine.medical_specialty medicine.medical_treatment 030218 nuclear medicine & medical imaging 03 medical and health sciences Prostate cancer 0302 clinical medicine Prostate Biopsy medicine Humans Radiology Nuclear Medicine and imaging Multiparametric Magnetic Resonance Imaging Aged Retrospective Studies Original Research Prostatectomy medicine.diagnostic_test Index Lesion business.industry Hazard ratio Prostatic Neoplasms Middle Aged Prognosis medicine.disease Immunohistochemistry Prostate-specific antigen medicine.anatomical_structure Case-Control Studies 030220 oncology & carcinogenesis Radiology business |
| Zdroj: | Radiology |
| Popis: | BACKGROUND: Although prostate MRI is routinely used for the detection and staging of localized prostate cancer, imaging-based assessment and targeted molecular sampling for risk stratification are an active area of research. PURPOSE: To evaluate features of preoperative MRI and MRI-guided biopsy immunohistochemistry (IHC) findings associated with biochemical recurrence (BCR) of prostate cancer after surgery. MATERIALS AND METHODS: In this retrospective case-control study, patients underwent multiparametric MRI before MRI-guided biopsy followed by radical prostatectomy between 2008 and 2016. Lesions were retrospectively scored with the Prostate Imaging Reporting and Data System (PI-RADS) (version 2) by radiologists who were blinded to the clinical-pathologic results. The IHC staining, including stains for the ETS-related gene, phosphatase and tensin homolog, androgen receptor, prostate specific antigen, and p53, was performed with targeted biopsy specimens of the index lesion (highest suspicion at MRI and pathologic grade) and scored by pathologists who were blinded to clinical-pathologic outcomes. Cox proportional hazards regression analysis was used to evaluate associations with recurrence-free survival (RFS). RESULTS: The median RFS was 31.7 months (range, 1–101 months) for 39 patients (median age, 62 years; age range, 47–76 years) without BCR and 14.6 months (range, 1–61 months) for 40 patients (median age, 59 years; age range, 47–73 years) with BCR. MRI features that showed a significant relationship with the RFS interval included an index lesion with a PI-RADS score of 5 (hazard ratio [HR], 2.10; 95% CI: 1.05, 4.21; P = .04); index lesion burden, defined as ratio of index lesion volume to prostate volume (HR, 1.55; 95% CI: 1.2, 2.1; P = .003); and suspicion of extraprostatic extension (EPE) (HR, 2.18; 95% CI: 1.1, 4.2; P = .02). Presurgical multivariable analysis indicated that suspicion of EPE at MRI (adjusted HR, 2.19; 95% CI: 1.1, 4.3; P = .02) and p53 stain intensity (adjusted HR, 2.22; 95% CI: 1.0, 4.7; P = .04) were significantly associated with RFS. CONCLUSION: MRI features, including Prostate Imaging Reporting and Data System score, index lesion burden, extraprostatic extension, and preoperative guided biopsy p53 immunohistochemistry stain intensity are associated with biochemical relapse of prostate cancer after surgery. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Costa in this issue. |
| Databáze: | OpenAIRE |
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