Post Prostatectomy Pathologic Findings of Patients With Clinically Significant Prostate Cancer and no Significant PI-RADS Lesions on Preoperative Magnetic Resonance Imaging
| Autor: | Nilesh S. Gupta, Kanika Taneja, James O. Peabody, Ali Dabaja, Mustafa Deebajah, Shaheen Alanee, Mani Menon, Sean R. Williamson, Daniel Cole, Milan Pantelic |
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| Rok vydání: | 2020 |
| Předmět: |
Image-Guided Biopsy
Male medicine.medical_specialty Prostate biopsy Biopsy Urology medicine.medical_treatment 030232 urology & nephrology urologic and male genital diseases 03 medical and health sciences Prostate cancer 0302 clinical medicine Prostate Humans Medicine Aged Retrospective Studies Aged 80 and over Prostatectomy medicine.diagnostic_test business.industry Prostatic Neoplasms Cancer Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging PI-RADS medicine.anatomical_structure 030220 oncology & carcinogenesis Radiology Neoplasm Grading business |
| Zdroj: | Urology. 146:183-188 |
| ISSN: | 0090-4295 |
| Popis: | Objectives We present postprostatectomy pathology results from a series of prostate cancer (Pca) Gleason grade group ≥2 patients who did not have findings suggestive of cancer on preoperative pelvic magnetic resonance imaging (MRI). Methods We performed an institutional retrospective study of prostate magnetic resonance imaging (MRI) examinations done from October 2015 to February 2018. We identified patients who underwent prostatectomy for Pca Gleason ≥3 + 4 diagnosed on prostate biopsy with no associated MRI findings suggestive of malignancy and analyzed their postprostatectomy pathologic findings and MRI imaging results. Results At our institution, 850 men with Pca received MRI between 2015 and 2018, and 156/850 patients received robotic-assisted radical prostatectomy. Thirty-three patients (33/156 = 21%) had negative MRI for PIRAD 3 or greater but had a biopsy showing significant Pca. Their mean (range) age was 62.7 (50-86) years. Their median (interquartile range) PSA, and PSA density were, 4.6 (3.7) ng/mL and 0.12 (0.05) ng/mL/cm2, respectively; all not significantly different from patients with visible lesions on MRI who underwent surgery. On post prostatectomy pathology, 27/33 (82%) men had Pca Gleason score 7 or greater. The most common pattern was infiltrative growth with cancer glands intermingling between benign glands. Conclusion We describe the pathologic and imaging findings in an extensive series of men with clinically significant Pca with no significant lesions on preoperative MRI. Our results support the importance of patient counseling on the risk of missing significant Pca on MRI in isolation from other clinical variables. |
| Databáze: | OpenAIRE |
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