Abstract
To evaluate the role of magnetic resonance spectroscopy imaging (MRSI) parameters to predict early biochemical recurrence (BCR) after radical prostatectomy (RP) in patients with non-metastatic prostate cancer (PCa). Between November 2010 and March 2012, 60 consecutive patients with clinically non-metastatic biopsy confirmed PCa underwent RP after MRSI assessment in a prospective study. Demographic, clinicopathological, magnetic resonance imaging (MRI) staging, MRSI parameters, and postoperative serum prostate-specific antigen were recorded. The univariate and multivariate Cox regression analyses were used to assess the association between potential prognosticators and early BCR (BCR less than 12 months after RP). In univariate Cox regression, preoperative serum PSA (prostate-specific antigen) (HR - hazard ratio = 1.016, p=0.003), surgical Gleason score > 7 (HR = 5.034, p=0.006) and MRSI risk score (HR = 4.061, p=0.0001); and in multivariate model, preoperative serum PSA (HR = 1.012; p=0.046), surgical GS > 7 (HR = 4.196; p=0.017) and MRSI risk score (HR = 3.256; p=0.013) were associated with early BCR. The greatest AUC (area under the curve) was related to MRSI risk score (AUC = 0.733) and the AUC of the multivariate model was 0.776. MRI/MRSI parameters specially MRSI risk score might be acceptable predictors of early BCR. These parameters can improve the accuracy of predictive nomograms to assess the risk of BCR after RP.
Highlights
Prostate cancer (PCa) is the second most common cancer in men (Parkin et al, 2005), that consists of 15% of all new cancers in men (Ferlay et al, 2015)
It has been demonstrated that magnetic resonance imaging (MRI) and magnetic resonance spectroscopy imaging (MRSI) are useful to predict oncological outcomes after radical prostatectomy (RP) (D’Amico et al, 2000; Pucar et al, 2004; Shukla-Dave et al, 2007)
biochemical recurrence (BCR) has been defined as a postoperative prostate-specific antigen (PSA) ≥ 0.4 ng/ml followed by an increasing PSA
Summary
Prostate cancer (PCa) is the second most common cancer in men (Parkin et al, 2005), that consists of 15% of all new cancers in men (Ferlay et al, 2015). Most of the prognosticators that predict oncological outcomes after radical prostatectomy (RP) are related to the surgical specimen (Kattan et al, 1998; Han et al, 2003; Stephenson et al, 2006). Pre-operative predictive factors could be valuable for prediction of RP outcomes and help urologists and patients to perform appropriate decision-making. It has been demonstrated that magnetic resonance imaging (MRI) and magnetic resonance spectroscopy imaging (MRSI) are useful to predict oncological outcomes after RP (D’Amico et al, 2000; Pucar et al, 2004; Shukla-Dave et al, 2007). We assess MRSI and MRI related prognosticators to predict the early biochemical recurrence (BCR) and time to early BCR after RP in patients with non-metastatic PCa
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