AUA 2017: Combined clinical parameters and multiparametric MRI for prediction of side-specific extraprostatic disease- a risk-model for patient-tailored risk stratification before radical prostatectomy

Boston, MA ( Dr. Radtke presented on the topic of using a risk model to help stratify patients with extraprostatic extension. They hypothesized that multi-parametric MRI improves the detection of clinically significant prostate cancer and extraprostatic extension. They used statistical modeling to develop the risk model which was validated with a cohort of prospective patients. The risk model they developed out performed other predictors of EPE including digital rectal exam, risk models developed by Steuber et al. and ESUR criteria (p=0.03). Area under the curve for the risk-model compared to DRE was 0.88 compared to 0.69 (p<0.01), for Steuber et al 0.77 (p=0.009) and for ESUR criteria 0.87 (p=0.006). Thus, the overall message of this study is that EPE prediction can be enhanced by the risk model they developed.

The risk model presented will help predict individual side-specific risk of EPE at the time of radical prostatectomy. This will be helpful to patients and surgeons. Patients will be able to make better informed decisions based on their disease process. While surgeons will be able to better counsel patients about the expectations of surgery and side effects, all while allowing surgeons to improve oncologic outcomes.

Presented by: Dr. Jan Philipp Radtke, MD from the University Hospital Heidelberg, Heidelberg, Germany

Written By: Janet Baack Kukreja (@janetkukreja), MD, MPH, Urologic Oncology Fellow, Department of Urology, UT MD Anderson Cancer Center, Houston, TX, Ashish M. Kamat, MD, MBBS, FACS, Wayne B. Duddlesten Professor, Department of Urology, UT MD Anderson Cancer Center, Houston TX

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA