311 Can We Predict Extraprostatic Extension (EPE) Prior To Radical Prostatectomy? – A Single Institution Comparison of Pre-Operative Biopsy Histology and Multiparametric MRI (mpMRI) With Radical Prostatectomy Specimen Histology

Abstract

Abstract Introduction Prostate biopsies and mpMRI play an integral role in diagnosis of prostate cancer. The aim of our study was to assess the ability to predict EPE based on pre-operative histology and mpMRI. Method We retrospectively analysed 235 patients who underwent radical prostatectomy between January 2015 and April 2017. All patients underwent pre-biopsy mpMRI scans and prostate biopsies. All mpMRIs were reported by dedicated uro-radiologists and all histology was reported by dedicated uro-pathologists. Results 17/25 patients showing EPE on mpMRI had it confirmed on final histology. a53/210 patients showing organ-confirmed disease on mpMRI had EPE on final histology. 40/49 patients who had Gleason 6 adenocarcinoma were organ-confined. 61/186 patients with > Gleason 7 adenocarcinoma had EPE. Sensitivity of mpMRI was 25% with a specificity of 95%. The positive predictive value (PPV) was 68% and negative predictive value (NPV) was 75%. The specificity of pre-biopsy Gleason score > 7 to predict EPE was 81% and sensitivity was 33% with a PPV of 87%. Conclusions Our data suggests that by using > Gleason 7 and mpMRI as a combination, we can reliably predict EPE on final histology which in turn will help counsel patients appropriately for treatment options. Further data collection is ongoing at our institution.