The role of mpMRI in qualification of patients with ISUP 1 prostate cancer on biopsy to radical prostatectomy.
Active surveillance
Gleason upgrading
MpMRI of prostate
PIRADS score
Prostate cancer
Journal
BMC urology
ISSN: 1471-2490
Titre abrégé: BMC Urol
Pays: England
ID NLM: 100968571
Informations de publication
Date de publication:
18 May 2021
18 May 2021
Historique:
received:
13
08
2020
accepted:
11
05
2021
entrez:
19
5
2021
pubmed:
20
5
2021
medline:
19
11
2021
Statut:
epublish
Résumé
To investigate the role of mpMRI and high PIRADS score as independent triggers in the qualification of patients with ISUP 1 prostate cancer on biopsy to radical prostatectomy. Between January 2017 and June 2019, 494 laparoscopic radical prostatectomies were performed in our institution, including 203 patients (41.1%) with ISUP 1 cT1c-2c PCa on biopsy. Data regarding biopsy results, digital rectal examination, PSA, mpMRI and postoperative pathological report have been retrospectively analysed. In 183 cases (90.1%) mpMRI has been performed at least 6 weeks after biopsy. Final pathology revealed ISUP Gleason Grade Group upgrade in 62.6% of cases. PIRADS 5, PIRADS 4 and PIRADS 3 were associated with Gleason Grade Group upgrade in 70.5%, 62.8%, 48.3% of patients on final pathology, respectively. Within PIRADS 5 group, the number of upgraded cases was statistically significant. PIRADS score correlates with an upgrade on final pathology and may justify shared decision of radical treatment in patients unwilling to repeated biopsies. However, the use of PIRADS 5 score as a sole indicator for prostatectomy may result in nonnegligible overtreatment rate.
Sections du résumé
BACKGROUND
BACKGROUND
To investigate the role of mpMRI and high PIRADS score as independent triggers in the qualification of patients with ISUP 1 prostate cancer on biopsy to radical prostatectomy.
METHODS
METHODS
Between January 2017 and June 2019, 494 laparoscopic radical prostatectomies were performed in our institution, including 203 patients (41.1%) with ISUP 1 cT1c-2c PCa on biopsy. Data regarding biopsy results, digital rectal examination, PSA, mpMRI and postoperative pathological report have been retrospectively analysed.
RESULTS
RESULTS
In 183 cases (90.1%) mpMRI has been performed at least 6 weeks after biopsy. Final pathology revealed ISUP Gleason Grade Group upgrade in 62.6% of cases. PIRADS 5, PIRADS 4 and PIRADS 3 were associated with Gleason Grade Group upgrade in 70.5%, 62.8%, 48.3% of patients on final pathology, respectively. Within PIRADS 5 group, the number of upgraded cases was statistically significant.
CONCLUSIONS
CONCLUSIONS
PIRADS score correlates with an upgrade on final pathology and may justify shared decision of radical treatment in patients unwilling to repeated biopsies. However, the use of PIRADS 5 score as a sole indicator for prostatectomy may result in nonnegligible overtreatment rate.
Identifiants
pubmed: 34006281
doi: 10.1186/s12894-021-00850-3
pii: 10.1186/s12894-021-00850-3
pmc: PMC8130114
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
82Références
J Surg Oncol. 2014 Jun;109(8):830-5
pubmed: 24610744
Eur Urol. 2016 Jan;69(1):41-9
pubmed: 26361169
Lancet. 2017 Feb 25;389(10071):815-822
pubmed: 28110982
Urol Oncol. 2015 May;33(5):202.e1-202.e7
pubmed: 25754621
J Urol. 2018 Oct;200(4):767-773
pubmed: 29733838
Int J Urol. 2016 Sep;23(9):752-7
pubmed: 27277398
N Engl J Med. 2018 May 10;378(19):1767-1777
pubmed: 29552975
Eur Urol. 2015 Apr;67(4):619-26
pubmed: 25457014
Eur Urol. 2016 Mar;69(3):428-35
pubmed: 26166626
J Urol. 2015 Aug;194(2):343-9
pubmed: 25681290
BJU Int. 2013 Mar;111(3):437-50
pubmed: 23279038
J Clin Oncol. 2015 Jan 20;33(3):272-7
pubmed: 25512465
Eur Urol Oncol. 2020 Feb;3(1):10-20
pubmed: 31492650
J Urol. 2005 Jun;173(6):1938-42
pubmed: 15879786
Int J Impot Res. 2012 Jul-Aug;24(4):161-4
pubmed: 22534563
Cochrane Database Syst Rev. 2019 Apr 25;4:CD012663
pubmed: 31022301
Eur Radiol. 2012 Apr;22(4):746-57
pubmed: 22322308
Prostate. 2019 Sep;79(13):1523-1529
pubmed: 31269285
J Urol. 2008 Dec;180(6):2436-40
pubmed: 18930486
Minerva Urol Nefrol. 2016 Jun;68(3):237-41
pubmed: 25732225
Urology. 2018 Aug;118:127-133
pubmed: 29792972
BJU Int. 2015 Aug;116(2):190-5
pubmed: 25430505
Urology. 2017 Aug;106:125-132
pubmed: 28438629