MP18-04 ROLE OF PI-RADS VERSION 2 FOR PREDICTION OF UPGRADING AFTER RADICAL PROSTATECTOMY IN PATIENTS WITH PROSTATE BIOPSY GLEASON SCORE 6

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology III1 Apr 2017MP18-04 ROLE OF PI-RADS VERSION 2 FOR PREDICTION OF UPGRADING AFTER RADICAL PROSTATECTOMY IN PATIENTS WITH PROSTATE BIOPSY GLEASON SCORE 6 Song Wan, Chan Kyo Kim, Young Hyo Choi, Hyun Woo Chung, Chung Un Lee, Jun Phil Na, Hwang Gyun Jeon, Byong Chang Jeong, Seong Il Seo, Seong Soo Jeon, Han Yong Choi, and Hyun Moo Lee Song WanSong Wan More articles by this author , Chan Kyo KimChan Kyo Kim More articles by this author , Young Hyo ChoiYoung Hyo Choi More articles by this author , Hyun Woo ChungHyun Woo Chung More articles by this author , Chung Un LeeChung Un Lee More articles by this author , Jun Phil NaJun Phil Na More articles by this author , Hwang Gyun JeonHwang Gyun Jeon More articles by this author , Byong Chang JeongByong Chang Jeong More articles by this author , Seong Il SeoSeong Il Seo More articles by this author , Seong Soo JeonSeong Soo Jeon More articles by this author , Han Yong ChoiHan Yong Choi More articles by this author , and Hyun Moo LeeHyun Moo Lee More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.614AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Accurate prediction of Gleason score (GS) after radical prostatectomy (RP) is important to determine treatment plans. However, 20-60% of patients with biopsy GS 6 are upgraded to GS 7 or more postoperatively. In this study, we evaluated whether Prostate Imaging Report and Data System version 2 (PI-RADSv2) has a role to predict upgrading after RP for patients with biopsy GS 6 METHODS We retrospectively reviewed 443 patients who underwent magnetic resonance imaging (MRI) and RP for prostate cancer with biopsy GS 6 between January 2011 and December 2013. Preoperative clinical parameters (prostate specific antigen [PSA], prostate volume, PSA density, number of positive core and maximum percentage of cancer per core), PI-RADS v2 score and pathologic GS were examined. Multivariate logistic regression was used to analyze predictive factors of upgrading after RP. Receiver operating characteristic (ROC) curves were used to analyze the predictive accuracies of multivariate logistic regression models and areas under the curves (AUCs) of ROC curves were compared. RESULTS Of 443 patients with biopsy GS 6, GS upgrading was identified in 297 (67.0%) patients (GS7, n=273 and GS8-10, n=24) following RP. PI-RADS v2 score 1-3, and 4-5 were identified in 157 (25.4%) and 286 (64.6%) patients, and upgrading rate after RP were 54.1% and 74.1%, respectively (p < 0.001). On multivariate analysis, PSA density > 0.16 ng/ml2, number of positive core = 2, maximum % cancer/core >20% and PI-RADS v2 score 4-5 were predictive factors of upgrading following RP (all p < 0.05). When predictive accuracies of multivariate models were compared using AUC from ROC curves, model 2 (PI-RADS v2 score 4-5 along with model 1) was found to have significantly higher accuracy then model 1(PSA density > 0.16 ng/ml2, number of positive core = 2 and maximum % cancer/core >20%) (0.729 vs 0.703, p = 0.041) CONCLUSIONS PSA density > 0.16 ng/ml2, number of positive core = 2 and maximum percentage of tumor length in a core > 20% are independent predictors of GS upgrading as preoperative variables. PI-RADSv2 4-5 confer an increased risk for GS upgrading that it may be used as a preoperative image tool to establish treatment decision. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e220 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Song Wan More articles by this author Chan Kyo Kim More articles by this author Young Hyo Choi More articles by this author Hyun Woo Chung More articles by this author Chung Un Lee More articles by this author Jun Phil Na More articles by this author Hwang Gyun Jeon More articles by this author Byong Chang Jeong More articles by this author Seong Il Seo More articles by this author Seong Soo Jeon More articles by this author Han Yong Choi More articles by this author Hyun Moo Lee More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...