The diagnostic accuracy of prostate cancer has been improved by the use of multiparametric magnetic resonance imaging (MRI). However, the role of the Prostate Imaging-Reporting and Data System (PI-RADS) score in combination with MRI in predicting issues after local prostate cancer treatment remains unclear. The aim of this study was to evaluate the PI-RADS score as a predictive factor for biochemical recurrence or progression (BCR) of prostate cancer.
This retrospective monocentric study included 304 men who underwent targeted prostate biopsies plus standard biopsies after MRI between 2017 and 2020. All the included patients had a PI-RADS score of at least 3. Survival probabilities were estimated by the Kaplan-Meier method. The hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between individual characteristics and BCR or progression were estimated using the Cox proportional hazards regression model for univariate and multivariate analyses. All tests were two-sided, and p < 0.05 was considered to indicate statistical significance. All analyses were performed using StatView software version 5.0 and MedCalc software version 17.5.
In total, 283 patients were included in our study. The median age at biopsy was 67.8 years, and the median follow-up was 4.9 years. The median time to BCR or progression after active surveillance (AS) was 4.7 years. A total of 22.3% of the patients experienced biochemical recurrence. No risk factors for biochemical recurrence according to the MRI PI-RADS score were significantly identified by univariate or multivariate analyses. Biochemical-free survival was 87% for the PI-RADS 5 group, 90% for the PI-RADS 4 and 80% for the PI-RADS 3 group at 3 years. There were no significant differences among these three groups in terms of BCR-free survival (p= 0.4).
In the present study, MRI lesion description with PI-RADS or the usual risk group did not seem to be sufficient to predict biochemical recurrence after local prostate cancer treatment, especially in our particular population. Future studies could pair the PI-RADS with histologic data of the prostatic index lesion to predict recurrence.
The French journal of urology. 2026 Apr 22 [Epub ahead of print]
Y Sadreux, K Kaulanjan, M Laguerre, P Mollard, G Gourtaud, C Senechal, P Blanchet, L Brureau
CHU de Pointe-à-Pitre, Service d'Urologie, 97159 Pointe-à-Pitre Cedex, France. Electronic address: ., CHU de Pointe-à-Pitre, Univ Antilles, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-97110 Pointe-à-Pitre, France., CHU de Pointe-à-Pitre, Service d'Urologie, 97159 Pointe-à-Pitre Cedex, France.