PD27-02 IS CAPSULAR ABUTMENT ON MRI A PREDICTOR OF EXTRAPROSTATIC EXTENSION (EPE) ON RADICAL PROSTATECTOMY?

Abstract

You have accessJournal of UrologyCME1 May 2022PD27-02 IS CAPSULAR ABUTMENT ON MRI A PREDICTOR OF EXTRAPROSTATIC EXTENSION (EPE) ON RADICAL PROSTATECTOMY? Mohammad Siddiqui, Jonathan Aguiar, Eric Li, Brandon Ansbro, Moataz Soliman, Mary-Kate Keeter, Quan Mai, Edward Schaeffer, and Ashley Ross Mohammad SiddiquiMohammad Siddiqui More articles by this author , Jonathan AguiarJonathan Aguiar More articles by this author , Eric LiEric Li More articles by this author , Brandon AnsbroBrandon Ansbro More articles by this author , Moataz SolimanMoataz Soliman More articles by this author , Mary-Kate KeeterMary-Kate Keeter More articles by this author , Quan MaiQuan Mai More articles by this author , Edward SchaefferEdward Schaeffer More articles by this author , and Ashley RossAshley Ross More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002575.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Extraprostatic extension (EPE) on radical prostatectomy (RP) pathology is an established prognostic indicator of recurrence and metastasis. Furthermore, suspicion of EPE guides neurovascular preservation during surgery. Here we investigate whether capsular ‘abutment’ on pre-operative mpMRI of the prostate predicts pathological findings. METHODS: We queried our prospectively collected institutional database from 2018 for all men undergoing radical prostatectomy (RP) who had undergone preoperative prostate MRI. Statistics were performed using t-test, chi-squared analysis, and logistical regressions with significance defined as p <0.05. RESULTS: 539 men underwent RP since March 2018. 307 (56%) men had pre-operative MRI. 163 (53.1%) had abutment of the capsule on MRI. For men with capsular abutment, 75 (46.25%) had EPE at prostatectomy (matched laterality in 42 (56%), on the contralateral side from their MRI lesion in 33 (44%)). 65/144 (45.1%) of men without capsular abutment on MRI had EPE on RP pathology. Men with ipsilateral EPE to their MRI lesions with capsular abutment were more likely to have a higher total prostate health index (PHI) (mean 64.20 vs. 50.95, p-value 0.024), and higher Gleason Grade Group (GG) lesion on diagnostic biopsy (p-value 0.001). Independent predictors of having ipsilateral EPE on multivariable logistic regression analysis include GG3 (OR 3.65, 95% CI 1.2-11.1) and GG4 (OR 4.7, 95%CI 1.2-18.8) on primary biopsy. On multivariable logistic regression analysis, MRI PIRADS scores were not predictive of either presence of ‘any’ EPE or ipsilateral EPE on final RP pathology. CONCLUSIONS: In our series, the presence or absence of “capsular abutment” alone read on MRI was a poor indicator of extra-prostatic extension on final pathology. Source of Funding: UROLOGY CARE FOUNDATION RESIDENCY RESEARCH AWARD © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e493 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohammad Siddiqui More articles by this author Jonathan Aguiar More articles by this author Eric Li More articles by this author Brandon Ansbro More articles by this author Moataz Soliman More articles by this author Mary-Kate Keeter More articles by this author Quan Mai More articles by this author Edward Schaeffer More articles by this author Ashley Ross More articles by this author Expand All Advertisement PDF DownloadLoading ...