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Low-risk Prostate Cancer Patients Without Visible Tumor (T1c) On Multiparametric MRI Could Qualify for Active Surveillance Candidate Even If They Did Not Meet Inclusion Criteria of Active Surveillance Protocol

Authors
 Dong Hoon Lee  ;  Kyo Chul Koo  ;  Seung Hwan Lee  ;  Koon Ho Rha  ;  Young Deuk Choi  ;  Sung Joon Hong  ;  Byung Ha Chung 
Citation
 JAPANESE JOURNAL OF CLINICAL ONCOLOGY, Vol.43(5) : 553-558, 2013 
Journal Title
 JAPANESE JOURNAL OF CLINICAL ONCOLOGY 
ISSN
 0368-2811 
Issue Date
2013
MeSH
Aged ; Clinical Protocols ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Magnetic Resonance Imaging*/methods ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Grading ; Odds Ratio ; Population Surveillance* ; Predictive Value of Tests ; Prostate-Specific Antigen/metabolism ; Prostatic Neoplasms/diagnosis* ; Prostatic Neoplasms/immunology ; Prostatic Neoplasms/pathology ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Watchful Waiting*
Keywords
low-risk prostate cancer ; magnetic resonance imaging ; active surveillance
Abstract
INTRODUCTION: We compared the pathologic outcomes of prostate cancer patients who did not qualify for active surveillance according to the tumor visibility on multiparametric magnetic resonance imaging. MATERIAL AND METHODS: We retrospectively analyzed 464 prostate cancer patients who underwent multiparametric magnetic resonance imaging before radical prostatectomy between 2006 and 2012. All the patients had clinically localized prostate cancer with Gleason score ≤6 and prostate-specific antigen ≤10 ng/ml. Of these patients, 238 were eligible for active surveillance (group A) and 226 were not. We divided these 226 patients into two groups according to the result of multiparametric magnetic resonance imaging: 59 (26.1%) patients without visible tumor (group B) and 167 (73.9%) patients with visible tumor (group C). We evaluated the pathologic outcomes of organ-confined Gleason ≤6 disease and unfavorable disease in each group. RESULTS: The proportions of organ-confined Gleason ≤6 disease and unfavorable disease were 63.9 and 11.3% in group A, 59.3 and 10.2% in group B, and 38.9 and 22.8% in Group C. Comparing group A and B, these proportions were not statistically different (P = 0.549 and P = 1.000, respectively). However, comparing group A and C, those were significantly different (P < 0.001 and P = 0.002, respectively). In multivariate logistic regression analysis, no visible tumor on multiparametric magnetic resonance imaging was an independent predictor of organ-confined Gleason score 6 disease (odds ratio 0.426, P = 0.007) but there was no statistically independent predictor for unfavorable disease. CONCLUSIONS: The tumor visibility on multiparametric magnetic resonance imaging could be a predictor of favorable disease for the prostate cancer patients who did not meet active surveillance criteria. Multiparametric magnetic resonance imaging could help to determine treatment modality for the low-risk prostate cancer patients who consider active surveillance even if they did not meet active surveillance criteria.
Files in This Item:
T201301637.pdf Download
DOI
10.1093/jjco/hyt041
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Kyo Chul(구교철) ORCID logo https://orcid.org/0000-0001-7303-6256
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Lee, Dong Hoon(이동훈)
Lee, Seung Hwan(이승환) ORCID logo https://orcid.org/0000-0001-7358-8544
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86933
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