Risk and predictors of adverse pathology after radical prostatectomy in patients diagnosed with IUSP 1-2 prostate cancer at MRI-targeted biopsy: a multicenter analysis.


Journal

World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716

Informations de publication

Date de publication:
Feb 2023
Historique:
received: 06 07 2022
accepted: 25 11 2022
pubmed: 20 12 2022
medline: 25 2 2023
entrez: 19 12 2022
Statut: ppublish

Résumé

Although active surveillance (AS) is recommended for low- to favorable intermediate-risk prostate cancer (PCa), risk of upgrading at radical prostatectomy (RP) is not negligible. Available studies based on systematic transrectal ultrasound biopsy might not be applicable to contemporary cohorts diagnosed with MRI-targeted biopsy (TB). The aim of the present study is to explore rates and risk factors for adverse outcomes (AO) at RP in patients with ISUP ≤ 2 PCa detected at TB with concomitant systematic biopsy (SB). Multicenter, retrospective analysis of 475 consecutive patients with ISUP ≤ 2 PCa at MRI-TB + SB is treated with RP. AO were defined as ISUP upgrading, adverse pathology (upgrading to ISUP ≥ 3 and/or ≥ pT3 at RP, and/or pN1) (AP) or biochemical recurrence (BCR) in men with follow-up (n = 327). The rate of ISUP upgrading, upgrading ≥ 3, and AP were 39%, 21%, and 43%. Compared to ISUP2, men with ISUP1 PCa had a higher rate of overall upgrading (27 vs. 67%, p < 0.001), but less upgrading to ≥ 3 (27 vs. 10%, p < 0.001). AP was more common when ISUP2 was detected with a combined MRI-TB + SB approach compared to considering TB (p = 0.02) or SB (p = 0.01) alone. PSA, PSA density, PI-RADS, ISUP at TB, overall biopsy ISUP and EAU classification were predictors of upgrading to ISUP ≥ 3 and AP. The 1 year BCR-free survival was 94% with no differences in BCR rates between subgroups. Upgrading in ISUP ≤ 2 PCa remains prevalent even in men diagnosed in the MRI era. The use of MRI-TB with concomitant SB allows for the accurate identification of ISUP2 PCa and predicts the risk of AO at RP.

Identifiants

pubmed: 36534151
doi: 10.1007/s00345-022-04236-4
pii: 10.1007/s00345-022-04236-4
pmc: PMC9947075
doi:

Substances chimiques

Prostate-Specific Antigen EC 3.4.21.77

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

427-434

Informations de copyright

© 2022. The Author(s).

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Auteurs

Claudia Kesch (C)

Department of Urology, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany. Claudia.Kesch@uk-essen.de.

Vlad Pantea (V)

Department of Urology, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany.

Timo Soeterik (T)

Department of Urology, St. Antonius Hospital, Nieuwegein-Utrecht, The Netherlands.

Alessandro Marquis (A)

Department of Urology, San Giovanni Battista Hospital, Città della Salute e della Scienza and University of Turin, Turin, Italy.

Giulia la Bombarda (G)

Department of Surgery, Oncology and Gastroenterology, Urology Clinic, University of Padova, Padua, Italy.

Allesandro Morlacco (A)

Department of Surgery, Oncology and Gastroenterology, Urology Clinic, University of Padova, Padua, Italy.

Francesco Barletta (F)

Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.

Jan Philipp Radtke (JP)

Department of Urology, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany.

Christopher Darr (C)

Department of Urology, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany.

Felix Preisser (F)

Department of Urology, University Hospital Frankfurt, Frankfurt, Germany.

Fabio Zattoni (F)

Department of Surgery, Oncology and Gastroenterology, Urology Clinic, University of Padova, Padua, Italy.

Giancarlo Marra (G)

Department of Urology, San Giovanni Battista Hospital, Città della Salute e della Scienza and University of Turin, Turin, Italy.

Roderik C N van den Bergh (RCN)

Department of Urology, St. Antonius Hospital, Nieuwegein-Utrecht, The Netherlands.

Boris Hadaschik (B)

Department of Urology, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany.

Giorgio Gandaglia (G)

Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.

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