MP55-04 THE PREOPERATIVE USE OF MICROUS TO DETECT EXTRAPROSTATIC EXTENSION OF PROSTATE CANCER: AN UPDATE OF A SINGLE INSTITUTIONAL PROSPECTIVE SERIES

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP55-04 THE PREOPERATIVE USE OF MICROUS TO DETECT EXTRAPROSTATIC EXTENSION OF PROSTATE CANCER: AN UPDATE OF A SINGLE INSTITUTIONAL PROSPECTIVE SERIES Vittorio Fasulo, Fabio De Carne, Edoardo Beatrici, Luca Disconzi, Nicola Frego, Pier Paolo Avolio, Marco Paciotti, Andrea Gobbo, Pietro Diana, Alessandro Uleri, Davide Maffei, Giuseppe Chiarelli, Paola Arena, Giuseppe Garofano, Alberto Saita, Rodolfo Hurle, Massimo Lazzeri, Nicolò Maria Buffi, Paolo Casale, and Giovanni Lughezzani Vittorio FasuloVittorio Fasulo More articles by this author , Fabio De CarneFabio De Carne More articles by this author , Edoardo BeatriciEdoardo Beatrici More articles by this author , Luca DisconziLuca Disconzi More articles by this author , Nicola FregoNicola Frego More articles by this author , Pier Paolo AvolioPier Paolo Avolio More articles by this author , Marco PaciottiMarco Paciotti More articles by this author , Andrea GobboAndrea Gobbo More articles by this author , Pietro DianaPietro Diana More articles by this author , Alessandro UleriAlessandro Uleri More articles by this author , Davide MaffeiDavide Maffei More articles by this author , Giuseppe ChiarelliGiuseppe Chiarelli More articles by this author , Paola ArenaPaola Arena More articles by this author , Giuseppe GarofanoGiuseppe Garofano More articles by this author , Alberto SaitaAlberto Saita More articles by this author , Rodolfo HurleRodolfo Hurle More articles by this author , Massimo LazzeriMassimo Lazzeri More articles by this author , Nicolò Maria BuffiNicolò Maria Buffi More articles by this author , Paolo CasalePaolo Casale More articles by this author , and Giovanni LughezzaniGiovanni Lughezzani More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003308.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Stratification of patients with localized prostate cancer (PCa) before robotic assisted radical prostatectomy (RARP) allows performing a tailor-made surgery, potentially providing a nerve-sparing procedure even in those patients with high-risk disease. Nowadays the accuracy of clinical parameters to determine extraprostatic extension (EPE) is moderate, so a new imaging tool capable of providing a more accurate assessment is in order. Our goal is to evaluate the added value of microUS in the preoperative prediction of EPE. METHODS: Our prospective single-institutional cohort study enrolled patients with diagnosis of PCa scheduled for RARP. We included patients with PSA<20 ng/mL, prostate volume<100 mL and a preoperative microUS investigation. MRI-derived features (curvilinear contact length [CCL], capsular bulging, visible extracapsular extension [ECE]), along with microUS features (such as the presence of hypoechoic halo and obliteration of the vesicle-prostatic angle) were tested as predictors of EPE. Multivariable logistic regression models were fitted to test the accuracy of clinical parameters (total PSA, ISUP biopsy and digital rectal examination [DRE]) plus microUS parameters for EPE prediction. RESULTS: Overall, 230 patients were recruited. All predictors were associated with non-organconfined disease (p<0.001). Histological findings showed that 131 (56.9%) and 99 (43.0%) had respectively a pT2 and a pT3 or greater disease. Individuals with only 1 predictor had a rate of non-organconfined PCa of 16.7% (OR 3.12), compared to 93.8% in those where 4 predictors were simultaneously observed (OR 75.0). At MLRM, the most significant risk factors for EPE were visible ECE (OR 3.23; p<0.004), positive DRE (OR 2.5;p=0.015), and PSA (OR 1.06; p=0.03). The AUC increased from 0.809 to 0.841 when considering the clinical model alone and the model including both clinical and microUS features respectively (Figure 1). The DeLong test for equality showed a significant difference between the two curves (p=0.04). CONCLUSIONS: Our results confirm that microUS may represent an accurate tool for the evaluation of non-organ confined PCa. Future studies should externally validate our findings and determine the impact of microUS in the outcomes of RARP. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e764 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Vittorio Fasulo More articles by this author Fabio De Carne More articles by this author Edoardo Beatrici More articles by this author Luca Disconzi More articles by this author Nicola Frego More articles by this author Pier Paolo Avolio More articles by this author Marco Paciotti More articles by this author Andrea Gobbo More articles by this author Pietro Diana More articles by this author Alessandro Uleri More articles by this author Davide Maffei More articles by this author Giuseppe Chiarelli More articles by this author Paola Arena More articles by this author Giuseppe Garofano More articles by this author Alberto Saita More articles by this author Rodolfo Hurle More articles by this author Massimo Lazzeri More articles by this author Nicolò Maria Buffi More articles by this author Paolo Casale More articles by this author Giovanni Lughezzani More articles by this author Expand All Advertisement PDF downloadLoading ...