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Clinical Significance of Multiparametric Magnetic Resonance Imaging as a Preoperative Predictor of Oncologic Outcome in Very Low-Risk Prostate Cancer

 Doo Yong Chung  ;  Min Seok Kim  ;  Jong Soo Lee  ;  Hyeok Jun Goh  ;  Dong Hoon Koh  ;  Won Sik Jang  ;  Chang Hee Hong  ;  Young Deuk Choi 
 Journal of Clinical Medicine, Vol.8(4) : E542, 2019 
Journal Title
 Journal of Clinical Medicine 
Issue Date
multiparametric MRI ; oncologic outcome ; preoperative predictor ; very low-risk prostate cancer
Currently, multiparametric magnetic resonance imaging (mpMRI) is not an indication for patients with very low-risk prostate cancer. In this study, we aimed to evaluate the usefulness of mpMRI as a diagnostic tool in these patients. We retrospectively analyzed the clinical and pathological data of individuals with very low-risk prostate cancer, according to the NCCN guidelines, who underwent mpMRI before radical prostatectomy at our institution between 2010 and 2016. Patients who did not undergo pre-evaluation with mpMRI were excluded. We analyzed the factors associated with biochemical recurrence (BCR) using Cox regression model, logistic regression analysis, and Kaplan⁻Meier curve. Of 253 very low-risk prostate cancer patients, we observed 26 (10.3%) with BCR during the follow-up period in this study. The median follow-up from radical prostatectomy was 53 months (IQR 33⁻74). The multivariate Cox regression analyses demonstrated that the only factor associated with BCR in very low-risk patients was increase in the pathologic Gleason score (GS) (HR: 2.185, p-value 0.048). In addition, multivariate logistic analyses identified prostate specific antigen (PSA) (OR: 1.353, p-value 0.010), PSA density (OR: 1.160, p-value 0.013), and suspicious lesion on mpMRI (OR: 1.995, p-value 0.019) as the independent preoperative predictors associated with the pathologic GS upgrade. In our study, the pathologic GS upgrade after radical prostatectomy in very low-risk prostate cancer patients demonstrated a negative impact on BCR and mpMRI is a good prognostic tool to predict the pathologic GS upgrade. We believe that the implementation of mpMRI would be beneficial to determine the treatment strategy for these patients.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Koh, Dong Hoon(고동훈)
Lee, Jong Soo(이종수) ORCID logo https://orcid.org/0000-0002-9984-1138
Jang, Won Sik(장원식) ORCID logo https://orcid.org/0000-0002-9082-0381
Chung, Doo Yong(정두용)
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Hong, Chang Hee(홍창희) ORCID logo https://orcid.org/0000-0002-0946-7702
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