PD61-09 INDEX TUMOR VOLUME ON MRI AS A PREDICTOR OF PATHOLOGIC OUTCOMES FOLLOWING RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Staging II1 Apr 2017PD61-09 INDEX TUMOR VOLUME ON MRI AS A PREDICTOR OF PATHOLOGIC OUTCOMES FOLLOWING RADICAL PROSTATECTOMY Dordaneh Sugano, Abhinav Sidana, Brian Calio, Sonia Gaur, Amit Jain, Mahir Maruf, Maria Merino, Peter Choyke, Baris Turkbey, Bradford Wood, and Peter Pinto Dordaneh SuganoDordaneh Sugano More articles by this author , Abhinav SidanaAbhinav Sidana More articles by this author , Brian CalioBrian Calio More articles by this author , Sonia GaurSonia Gaur More articles by this author , Amit JainAmit Jain More articles by this author , Mahir MarufMahir Maruf More articles by this author , Maria MerinoMaria Merino More articles by this author , Peter ChoykePeter Choyke More articles by this author , Baris TurkbeyBaris Turkbey More articles by this author , Bradford WoodBradford Wood More articles by this author , and Peter PintoPeter Pinto More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2768AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Tumor volume measured on radical prostatectomy (RP) specimen has been shown to be associated with adverse pathologic and oncologic outcomes; however, it is difficult to calculate and cannot contribute to preoperative decision making. Advances in imaging technology may facilitate the prediction of prostate cancer outcomes prior to surgery. In this study, we evaluated the predictive value of the index tumor volume (ITV) calculated from prostate MRI in analyzing adverse pathologic outcomes following RP in a higher risk cohort. METHODS Clinical and pathologic data from a prospectively maintained, single-institution database were analyzed for patients who underwent 3T MRI prior to RP (without prior therapy) between 2007 and 2016, with an index tumor defined as a T2-visible lesion with the longest diameter. ITV was calculated from T2W MRI by multiplying length by width by depth by 0.52 to generate the volume of an ellipse. Adverse pathologic outcomes were determined on whole mount RP specimens, and defined as positive margins (PM), extracapsular extension (ECE), positive lymph nodes (LNI), and seminal vesicle invasion (SVI). Logistic regression was used to assess associations of clinical, imaging, and histopathological variables with adverse pathologic features. Receiver operating characteristic curves were used to characterize and compare ITV performance with Partin tables. RESULTS In our study period, 464 patients met our inclusion criteria. In our cohort, median age and PSA were 60 years (IQR 10) and 6.21 ng/ml (IQR 6), and 24.4% were ″high risk″ (Gleason 8-10) on biopsy . 15.6% of patients had PM, 23.5% ECE, 6.3% LNI, and 6.5% SVI. Patients with adverse outcomes were found to have larger median ITV (PM: 1.236cc vs 0.832cc, p=0.045; ECE: 1.388cc vs 0.771cc, p<0.001; LNI: 2.750cc vs 0.801cc, p<0.001; SVI: 2.269cc vs 0.806cc, p<0.001). On multivariate analysis, ITV was found to be an independent predictor of ECE (OR: 1.211, p=0.005), LNI (OR: 1.366, p<0.001), and SVI (OR: 1.305, p=0.002), but not PM (OR: 1.052, p=0.300). ITV alone and ITV+PSA were found to have predictive ability comparable to that of Partin tables (ECE: ITVAUC: 0.660 vs. ITV+PSAAUC:0.721 vs. PartinAUC: 0.717, LNI: ITVAUC: 0.802 vs. ITV+PSAAUC:0.881 vs. PartinAUC: 0.873, SVI: ITVAUC: 0.749 vs. ITV+PSAAUC:0.762 vs. PartinAUC: 0.806). CONCLUSIONS We demonstrate that Index Tumor Volume measured on T2W MRI is an independent predictor of ECE, LNI, and SVI following RP. We believe this easily calculated preoperative marker provides additional prognostic information, particularly in higher risk cohorts. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1191 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Dordaneh Sugano More articles by this author Abhinav Sidana More articles by this author Brian Calio More articles by this author Sonia Gaur More articles by this author Amit Jain More articles by this author Mahir Maruf More articles by this author Maria Merino More articles by this author Peter Choyke More articles by this author Baris Turkbey More articles by this author Bradford Wood More articles by this author Peter Pinto More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...