SEARCH

SEARCH BY CITATION

Keywords:

  • prostate cancer;
  • MRI;
  • PSA;
  • biochemical recurrence;
  • clinical stage;
  • radical prostatectomy

Objective

  • To evaluate the suitability of preoperative multiparametric magnetic resonance imaging (MRI) positivity as a predictor of biochemical recurrence after radical prostatectomy (RP).

Patients and Methods

  • We reviewed the clinical records of patients who underwent either standard RP or laparoscopic RP between January 2005 and December 2009 at our institution.
  • Patients who received radiotherapy or androgen deprivation therapy before surgery were excluded. A total of 314 patients met the study inclusion criteria.
  • Cox proportional hazard regression models were used for analyses.
  • In accordance with the criteria in the established guidelines, a radiologist scored the probability of the presence of prostate cancer using a five-point scale of diagnostic confidence level. The highest confidence level of any pulse sequence was considered as the evaluation result.

Results

  • MRI positivity was significantly associated with a high clinical stage (cT ≥ 2; P = 0.039), a high positive biopsy core rate (≥0.2; P < 0.001), a high biopsy Gleason score ([GS] ≥8; P < 0.001) and a high pathological GS (≥8; P = 0.005).
  • Univariate analysis and multivariate analysis showed that MRI positivity was a prognostic indicator in the analysis that included only preoperative variables and also in the analysis including preoperative and pathological variables.

Conclusion

  • Multiparametric MRI positivity can independently predict biochemical recurrence after RP.