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The significance of the visible tumor on preoperative magnetic resonance imaging in localized prostate cancer

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Author(s)
Teak Jun ShinWonho JungJi Yong HaByung Hoon KimYoung Hwan Kim
Keimyung Author(s)
Shin, Teak JunJung, Won HoKim, Byung HoonKim, Young Hwan
Department
Dept. of Urology (비뇨의학)
Dept. of Radiology (영상의학)
Journal Title
Prostate Int
Issued Date
2021
Volume
9
Issue
1
Keyword
Biochemical recurrenceLocalized prostate cancerMagnetic resonance imagingVisible tumors
Abstract
Objectives:
We investigated the relationship between tumor characteristics and visible tumors on magnetic resonance imaging (MRI) and examined the prognosis of tumor detection on MRI compared with no tumor detection in localized prostate cancer.

Materials and methods:
We reviewed 214 patients with pT2N0M0 prostate cancer who underwent radical prostatectomy between January 2009 and December 2016. All the patients underwent MRI preoperatively. The patients were divided into 2 groups postoperatively: no visible tumor on the MRI group (n = 96, 44.9%) and visible tumor on the MRI group (n = 118, 55.1%). The visible tumor was defined as Prostate Imaging Reporting and Data System, version 2 Grade ≥ 3 on MRI. Age, prostate-specific antigen, prostate volume, positive surgical margin (PSM), lymphovascular invasion, and biochemical recurrence (BCR) were compared between the 2 groups. We also assessed the relationship between visible tumors on MRI and oncologic characteristics.

Results:
The visible tumor on the MRI group showed a higher Gleason score ≥4 + 3 [45.8% versus (vs.) 17.7%], high frequency of postoperative PSMs (28.8% vs. 16.7%), and higher BCR rate (17.8% vs. 7.3%) than the no visible tumor on the MRI group. The Kaplan–Meier analysis for BCR-free survival also showed a significant difference (P = 0.006). In multivariate Cox regression analysis, the detection of tumors on MRI was associated with a higher BCR risk [hazard ratio: 3.35; 95% confidence interval (CI): 1.36-8.27; P = 0.009]. We found a positive association between visible tumors on MRI and primary Gleason pattern of ≥4 (odds ratio: 4.31; 95% CI: 2.21–8.40; P < 0.001).

Conclusions:
In localized prostate cancer, BCR was significantly more frequent when the tumor was detected on MRI, and a visible tumor on MRI was associated with the Gleason score. Therefore, attention should be paid to the possibility of high-grade prostate cancer when a tumor is detected on MRI before radical prostatectomy, and active follow-up may be needed postoperatively.
Keimyung Author(s)(Kor)
신택준
정원호
김병훈
김영환
Publisher
School of Medicine (의과대학)
Citation
Teak Jun Shin et al. (2021). The significance of the visible tumor on preoperative magnetic resonance imaging in localized prostate cancer. Prostate Int, 9(1), 6–11. doi: 10.1016/j.prnil.2020.06.001
Type
Article
ISSN
2287-8882
Source
https://www.sciencedirect.com/science/article/pii/S2287888220300441
DOI
10.1016/j.prnil.2020.06.001
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43724
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
1. School of Medicine (의과대학) > Dept. of Urology (비뇨의학)
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