The aim of this study was to investigate the prognostic performance of multiparametric magnetic resonance imaging (mpMRI) and Prostate Imaging Reporting and Data System (PIRADS) score in predicting pathologic features in a cohort of patients eligible for active surveillance who underwent radical prostatectomy.
A total of 223 patients who fulfilled the criteria for "Prostate Cancer Research International: Active Surveillance", were included. Mp-1. 5 Tesla MRI examination staging with endorectal coil was performed at least 6-8 weeks after TRUS-guided biopsy. In all patients, the likelihood of the presence of cancer was assigned using PIRADS score between 1 and 5. Outcomes of interest were: Gleason score upgrading, extra capsular extension (ECE), unfavorable prognosis (occurrence of both upgrading and ECE), large tumor volume (≥0. 5ml), and seminal vesicle invasion (SVI). Receiver Operating Characteristic (ROC) curves and Decision Curve Analyses (DCA) were performed for models with and without inclusion of PIRADS score.
Multivariate analysis demonstrated the association of PIRADS score with upgrading (P
mpMRI and PIRADS scoring are feasible tools in clinical setting and could be used as decision-support systems for a more accurate selection of patients eligible for AS.
PloS one. 2015 Oct 07*** epublish ***
Ottavio de Cobelli, Daniela Terracciano, Elena Tagliabue, Sara Raimondi, Danilo Bottero, Antonio Cioffi, Barbara Jereczek-Fossa, Giuseppe Petralia, Giovanni Cordima, Gilberto Laurino Almeida, Giuseppe Lucarelli, Carlo Buonerba, Deliu Victor Matei, Giuseppe Renne, Giuseppe Di Lorenzo, Matteo Ferro
Division of Urology, European Institute of Oncology, Milan, Italy. , Department of Translational Medical Sciences, University "Federico II", Naples, Italy. , Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy. , Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy. , Division of Urology, European Institute of Oncology, Milan, Italy. , Division of Urology, European Institute of Oncology, Milan, Italy. , Department of Radiotherapy, European Institute of Oncology, Milan, Italy. , Department of Radiology, European Institute of Oncology, Milan, Italy. , Division of Urology, European Institute of Oncology, Milan, Italy. , University of Vale do Itajaí, Catarinense Institute of Urology, Division of Laparoscopy, Itajaí, Brazil. , Department of Emergency and Organ Transplantation, Urology and Kidney Transplantation Unit, University of Bari, Bari, Italy. , Division of Medical Oncology, CROB-IRCCS, Rionero in Vulture, Italy. , Division of Urology, European Institute of Oncology, Milan, Italy. , Division of Pathology, European Institute of Oncology, Milan, Italy. , Medical Oncology Unit, Department of Clinical Medicine, Federico II University, Naples, Italy. , Division of Urology, European Institute of Oncology, Milan, Italy.