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Is suspicious upstaging on multiparametric magnetic resonance imaging useful in improving the reliability of Prostate Cancer Research International Active Surveillance (PRIAS) criteria? Use of the K-CaP registry

Authors
 Sangjun Yoo  ;  Jun Hyuk Hong  ;  Seok-Soo Byun  ;  Ji Youl Lee  ;  Byung Ha Chung  ;  Choung-Soo Kim 
Citation
 Urologic Oncology - Seminars and Original Investigations, Vol.35(7) : e7-e13, 2017 
Journal Title
 Urologic Oncology - Seminars and Original Investigations 
ISSN
 1078-1439 
Issue Date
2017
MeSH
Humans ; Korea ; Magnetic Resonance Imaging/methods* ; Male ; Middle Aged ; Prostatectomy/methods* ; Prostatic Neoplasms/epidemiology* ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/surgery ; Registries ; Reproducibility of Results
Keywords
Magnetic resonance imaging ; Pathology ; Prostatectomy ; Prostatic neoplasms
Abstract
BACKGROUND AND OBJECTIVE: To evaluate the clinical effects of suspicious upstaging on multiparametric magnetic resonance imaging (mpMRI) for improving the quality of Prostate Cancer Research International Active Surveillance (PRIAS) criteria. MATERIAL AND METHODS: A total of 363 patients with low-risk prostate cancer (PCa) were selected from the K-CaP registry (the multicenter Korean PCa Database). Patients were divided into 2 groups according to the results of mpMRI (with or without suspicious upstaging). The variables for predicting significant PCa, defined as locally advanced PCa, Gleason score≥7, or tumor volume>0.5cc or all of these, and adverse PCa, defined as locally advanced PCa, Gleason score≥7 (4+3), or tumor volume>2.5cc or all of these, were assessed. RESULTS: The mpMRI led to "suspicious" upstaging in 56 patients (15.4%). Significant PCa (98.2% vs. 74.6%, P<0.001) and adverse PCa (85.7% vs. 32.6%, P<0.001) were more common in patients with suspicious upstaging. The sensitivity/specificity of mpMRI for significant PCa and adverse PCa were 25.4%/98.2% and 32.4%/96.3%, respectively. On multivariate analyses, suspicious upstaging on mpMRI (odds ratio: 15.82, P = 0.007) was a predictor for significant PCa in addition to PRIAS criteria and age at diagnosis. In addition, suspicious upstaging on mpMRI (odds ratio: 11.11, P<0.001) was a significant predictor for adverse PCa in addition to PRIAS criteria, age at diagnosis, and body mass index. CONCLUSION: Along with the PRIAS criteria, suspicious upstaging on mpMRI is a potent diagnostic tool for distinguishing patients suitable for active surveillance among patients with low-risk PCa.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161174
DOI
10.1016/j.urolonc.2016.07.014
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실)
Yonsei Authors
정병하(Chung, Byung Ha)
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Full Text
https://www.sciencedirect.com/science/article/pii/S1078143916302009
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