Construction of a Preoperative Radiologic-Risk Signature for Predicting the Pathologic Status of Prostate Cancer at Radical Prostatectomy

We developed a radiologic-risk signature (RRS) that serves as a surrogate for the pathologic status of prostate cancer (PCA) and investigated its ability to predict disease-free survival.

This study included 631 patients with localized PCA who underwent prostatic multiparametric MRI before prostatectomy. Images from 426 training datasets were structurally interpreted and correlated to a postoperative Memorial Sloan Kettering Cancer Center (MSKCC) score by a stepwise partial least-squares regression analysis. The developed RRS, compared with a preoperative Kattan nomogram, was validated in a cohort of 205 patients with 3-year follow-up data after prostatectomy in terms of calibration, discrimination, and clinical usefulness. Statistical tests were performed by AUC analysis, Kaplan-Meier test, and decision curve analysis.

The RRS, which consists of 12 preoperative variables, faithfully represented postoperative MSKCC score in 426 training (r = 0.75; p < 0.001) and 205 validation (r = 0.79; p < 0.001) datasets. For patients in the validation group, RRS showed better discriminative power (C-index, 0.859; 95% CI, 0.779-0.939; p = 0.013) than did the preoperative Kattan nomogram (C-index, 0.780; 95% CI, 0.701-0.859) for predicting 3-year biochemical recurrence and showed higher net benefits for a probability threshold of greater than 10%.

Characteristics of RRS can faithfully represent the tumor pathologic status and predict accurately the disease postoperative outcome before prostatectomy.

AJR. American journal of roentgenology. 2018 Jul 11 [Epub ahead of print]

Liang Qi, Chen-Jiang Wu, Jing Zhang, Mei-Ling Bao, Xu Yan, Yu-Dong Zhang

1 Department of Radiology, First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Rd, Nanjing, Jiangsu Province 210009, China., 2 Department of Pathology, First Affiliated Hospital, Nanjing Medical University, Nanjing, China., 3 MR Collaboration NE Asia, Siemens Healthcare, Shanghai, China.

E-Newsletters

Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.

Subscribe