High Prognostic Ability Research Articles

Nomogram-based prediction of survival in unresectable or metastatic gastric cancer patients with good performance status who received first-line chemotherapy.

BackgroundGood performance status (PS) is widely acknowledged to have a high prognostic ability, although the prognostic parameters of cancer patients with good PS are still uncertain. This study was conducted to establish and validate a point-based nomogram to assist with predicting prognosis in unresectable or metastatic gastric cancer (GC) patients who had good PS and underwent first-line chemotherapy.MethodsAt random, a total of 309 patients with GC were split into 2 cohorts: a training cohort (n=259) and an internal validation cohort (n=50). An independent external validation cohort comprising 147 patients was also recruited. Both univariate and multivariate Cox regression analyses were used to evaluate patients based on the overall survival (OS) to develop the nomogram, which was subsequently validated using the concordance index (c-index), calibration curve, and decision curve analysis (DCA).ResultsThe nomogram contained 3 independent prognostic variables in the training cohort: the number of distant metastatic sites (P<0.001), carbohydrate antigen 199 (CA199) level (P=0.002), and fibrinogen (P=0.020). The nomogram predicted an OS with a c-index of 0.623 (95% CI, 0.58–0.67) in the training cohort. The internal validation showed that the nomogram had a c-index of 0.614 (95% CI, 0.51–0.72). For external validation, the c-index was 0.638 (95% CI, 0.58–0.70).ConclusionsA reliable point-based nomogram for predicting the prognosis of patients who had unresectable or metastatic GC and good PS who underwent first-line chemotherapy was developed and validated.KeywordsNomogram-based prediction; overall survival; unresectable gastric cancer; metastatic gastric cancer; good performance status; first-line chemotherapy

1179 Echocardiographic signs of aortic atherosclerosis in combination with clinical parameters for prediction of non-obstructive coronary atherosclerosis in men

Abstract Background Traditionally the gold standard for diagnosis of coronary artery disease (CAD) is detection of significant stenosis by coronary angiography. However, most myocardial infarctions result from ruptures of plaques that did not significantly compromise coronary lumen before the event. It was proved that significant stenosis is associated with stable CAD but non-significant coronary atherosclerosis is associated with unstable angina and acute coronary syndrome. Purpose To reveal predictors of non-significant coronary atherosclerosis using echocardiographic and clinical parameters in suspected CAD men without obstructive CAD by coronary angiography. Methods Out of 17.784 patients from coronary angiography database we selected 1.957 men without obstructive CAD. Selected men were divided into two groups randomly (1.389 - studied group and 568 – test group). The studied group was divided into subgroups: 304 men with non-significant coronary atherosclerosis (luminal narrowing or stenosis less than 30%) and 1.085 men with smooth coronary artery. Clinical and functional parameters of subgroups patients were compared. For selection of scoring variables, we used the values of the Cramer coefficient and the information value index - IV. All quantitative variables were converted into categorical using the binning procedure. Based on the values of WoE, the model of logistic regression was constructed using stepwise variable selection. Results The model includes independent variables with an average and high prognostic ability: echocardiographic signs of atherosclerosis of the ascending aorta, age, atherogenic index, arterial hypertension. By converting the coefficients of the logistic regression equation obtained into scores, a scoring model was developed to assess the probability of non-obstructive coronary atherosclerosis in men. Based on ROC analysis, in the studied group the specificity of the model for detection of nonsignificant coronary atherosclerosis was 67%, the sensitivity was 65%, the area under the ROC curve - 0.711. For the patients of the test group sensitivity was 68% and specificity - 63%, the area under the ROC curve - 0.687. Conclusion Nonsignificant coronary atherosclerosis in men with suspected CAD can be predicted before CAG by screening test based on echocardiographic signs of aortic atherosclerosis, age, atherogenic index and arterial hypertension.

THE APPLICATION OF SYSTEMIC-COGNITIVE ANALYSIS IN THE INDUSTRY FORECASTING THE FINANCIAL SITUATION OF ENTERPRISES (FOR EXAMPLE CONSTRUCTION INDUSTRY)

The article is devoted to the development of an industry model for assessing the financial position of enterprises using the method of automated system-cognitive analysis. It is proved that the existing models have not enough high prognostic ability regarding the financial position of enterprises in a particular industry. The models do not take into account the peculiarities of the financial reporting structure, which directly depends on the specifics of the field of activity. In the sample of the study included domestic construction companies. On the basis of their balance sheets identified the main financial signs of bankruptcy and economic prosperity. In addition, a reliable model for assessing the financial situation has been developed.

Determination of serum neutrophil gelatinase-associated lipocalin as a prognostic biomarker of acute spontaneous intracerebral hemorrhage

BackgroundNeutrophil gelatinase-associated lipocalin (NGAL) is currently known as an acute phase protein and implicated in acute brain injury. Herein, we sought to gauge serum NGAL level in patients after acute (<24 h) spontaneous intracerebral hemorrhage (ICH) and to investigate its relation to neurological outcome. MethodsSerum NGAL levels were measured in 106 patients and 106 controls. National Institutes of Health Stroke Scale (NIHSS) score, Glasgow coma scale (GCS) score, ICH score and hematoma volume were recorded for assessing hemorrhagic severity. An unfavorable outcome was defined as modified Rankin Scale >2 at 90 days. ResultsAs opposed to the controls, the patients had significantly raised serum NGAL levels. Correlations were observed between NGAL levels and serum C-reactive protein levels, blood glucose levels, GCS score, NIHSS score, ICH score and ICH volume. Multivariate analysis identified serum NGAL as a predictor for unfavorable outcome at 90 days. It also showed high prognostic ability under receiver operating characteristic curve. ConclusionsEnhanced NGAL level is revealed after acute spontaneous ICH, in association with inflammatory degree and hemorrhagic severity, and intimately correlated with a worse prognosis.

QSAR-modeling of desoxyuridine triphosphatase inhibitors in a series of some derivatives of uracil

Due to the widespread prevalence, deoxyuridine triphosphatase (UTPase) is considered by modern biochemists and physicians as a promising target for the development of drugs with a wide range of activities. The therapeutic effect of these drugs will be due to suppression of DNA biosynthesis in various viruses, bacteria and protozoa. In order to rationalize the search for new dUTPase inhibitors, domestic and foreign researchers are actively using the QSAR methodology at the selection stage of hit compounds. However, the practical application of this methodology is impossible without existence of valid QSAR models. With the use of the GUSAR 2013 program, a quantitative analysis of the relationship between the structure and efficacy of 135 dUTPase inhibitors based on uracil derivatives was performed in the IC50 range of 30¸185000 nmol/L. Six statistically significant valid consensus models, characterized by high descriptive ability and moderate prognostic ability on the structures of training and test samples, are constructed. To build valid QSAR models for dUTPase inhibitors can use QNA or MNA descriptors and their combinations in a consensus approach.

MODEL FOR ASSESSING THE PROBABILITY OF REVOCATION OF A LICENSE FROM THE RUSSIAN BANK

The article deals with the problem of modeling and forecasting the revocation of the bank’s license depending on the volatility of macroeconomic variables. The urgency of this problem is due to the following reasons. First, the Central Bank of theRussian Federationtoday pursues a policy of clearing the banking sector from unscrupulous participants in the banking market and from banks with weak economic positions. Secondly, the strong fl in the values of macroeconomic variables over the previous few years affect the financial condition of the bank, which is the basis for the decision to revoke the license. The purpose of the article is to develop a model for assessing the probability of revocation of a license from the Russian bank on the basis of its public financial statements, taking into account the volatility of macroeconomic variables. The author has developed a logistic regression model for assessing the probability of revocation of a license from the Russian bank taking into account the volatility of macroeconomic variables. To level the effect of multicollinearity in the data, we use RIDGE modification of the logistic regression model with a certain algorithm for setting the penalty factor. The model is based on the data of official public bank statements, data on macroeconomic variables, and data on license revocations by the Bank of Russia as well. To aggregate the information and bring it into a single format, an information and logical model for the formation of the information base of the study is developed. The obtained model for assessing the probability of revocation of a license from the Russian bank has a high prognostic ability. The hypothesis of statistical difference of coefficients from zero is accepted when indicators of volatility of macroeconomic variables were at significance levels of 0.01 and above. The author concluded that the volatility of macroeconomic variables has a significant impact on the fi condition of the bank. The Bank of Russia takes this into account when deciding whether to revoke a license, as the fi condition is one of the key aspects. This approach can be used by the bank’s counterparties in assessing its reliability.

Prognostic value of cancer antigen -125 for lung adenocarcinoma patients with brain metastasis: A random survival forest prognostic model

Using random survival forest, this study was intended to evaluate the prognostic value of serum markers for lung adenocarcinoma patients with brain metastasis (BM), and tried to integrate them into a prognostic model. During 2010 to 2015, the patients were retrieved from two medical centers. Besides the Cox proportional hazards regression, the random survival forest (RSF) were also used to develop prognostic model from the group A (n = 142). In RSF of the group A, the factors, whose minimal depth were greater than the depth threshold or had a negative variable importance (VIMP), were firstly excluded. Subsequently, C-index and Akaike information criterion (AIC) were used to guide us finding models with higher prognostic ability and lower overfitting possibility. These RSF models, together with the Cox, modified-RPA and lung-GPA index were validated and compared, especially in the group B (CAMS, n = 53). Our data indicated that the KSE125 model (KPS, smoking, EGFR-20 (exon 18, 19 and 21) and Ca125) was the best in survival prediction, and performed well in internal and external validation. In conclusions, for lung adenocarcinoma patients with brain metastasis, a validated prognostic nomogram (KPS, smoking, EGFR-20 and Ca125) can more accurately predict 1-year and 2-year survival of the patients.

Molecular Screening of Small Biopsy Samples Using Next-Generation Sequencing in Korean Patients with Advanced Non-small Cell Lung Cancer: Korean Lung Cancer Consortium (KLCC-13-01).

BackgroundNon-small cell lung cancer (NSCLC) is a common type of cancer with poor prognosis. As individual cancers exhibit unique mutation patterns, identifying and characterizing gene mutations in NSCLC might help predict patient outcomes and guide treatment. The aim of this study was to evaluate the clinical adequacy of molecular testing using next-generation sequencing (NGS) for small biopsy samples and characterize the mutational landscape of Korean patients with advanced NSCLC.MethodsDNA was extracted from small biopsy samples of 162 patients with advanced NSCLC. Targeted NGS of genomic alterations was conducted using Ion AmpliSeq Cancer Hotspot Panel v2.ResultsThe median age of patients was 64 years (range, 32 to 83 years) and the majority had stage IV NSCLC at the time of cancer diagnosis (90%). Among the 162 patients, 161 patients (99.4%) had novel or hotspot mutations (range, 1 to 21 mutated genes). Mutations were found in 41 genes. Three of the most frequently mutated genes were TP53 (151, 93.2%), KDR (104, 64.2%), and epidermal growth factor receptor (EGFR; 69, 42.6%). We also observed coexistence of EGFR and other oncogene (such as KRAS, PIC3CA, PTEN, and STK11) mutations. Given that 69.6% (48/69) of EGFR mutant patients were treated with EGFR tyrosine kinase inhibitors, EGFR mutant status had higher prognostic ability in this study.ConclusionsThese results suggest that targeted NGS using small biopsy samples is feasible and allows for the detection of both common and rare mutations in NSCLC.

Применение айтрекинга в практике профессионального отбора кадров

The article discusses the results of the application of the eye tracker and the polygraph in the practice of professional selection of personnel. The obtained experimental data indicate the high prognostic ability diagnostics using eye tracking in the selection of personnel.

Whole blood mRNA expression for prognosis of metastatic clear cell renal carcinoma (mCCRCC).

500 Background: The Memorial Sloan Kettering Cancer Center (MSKCC) prognostic score is based on clinical parameters and has several limitations. We analyzed whole blood mRNA expression in mCCRCC patients (pts) and compared it to MSKCC for predicting overall survival (OS). Methods: A prospective collection of whole blood in PAXgene RNA tubes from mCCRCC pts was performed between 2011 and 2015 with uniform processing. A discovery set (DS) of 19 randomly selected pt samples was used to generate whole transcriptome RNA sequencing and signatures describing differential gene expression patterns associated with OS. We calculated the fragment per kilobase of transcript per million (FPKM) of each transcript and gene to identify correlations between the differentially expressed genes and MSKCC score. Candidate genes were selected based on statistical significance (p&lt;0.05) and associations with OS. In an independent validation set (VS) of 47 pts with mCCRCC, we used the nCounter Analysis System (NanoString Technologies, Seattle, WA, USA) to quantify gene transcript expression selected from the DS. Cox regression and Kaplan-Meier analysis were used for association of candidate mRNAs in the VS with OS (time of metastatic recurrence to death or last follow-up). We compared our gene signature to the MSKCC prognostic score for poor versus good survival. Results: In the DS, at a median follow-up of 4.13 years (yrs) (range: 1.3-4.5), 11 patients had died. We identified eighteen genes in the DS with statistically significant differential gene expression patterns and ability to discriminate patient OS. In the VS at a median follow-up of 4.9 yrs (range: 0.1-11.3), twenty-five patients had died. We confirmed two of the eighteen selected genes that had strong prognostic significance: BAG1 [hazard ratio (HR) 0.31, p=0.007] and NOP56 [HR 0.28, p=0.004]. Comparing OS between good and poor outcome groups for these 2 scores, our two-gene panel had higher prognostic ability (HR 20.07, p &lt;0.0001) than the MSKCC prognostic score (HR 3.19, p 0.04). Conclusions: Prognostic value of using whole blood mRNA gene profiling in mCCRCC is feasible and should be prospectively confirmed in larger studies.

Kinetics of Adsorbable Organic Halogen Formation During the First Chlorine Dioxide Bleaching Stage of Eucalyptus Kraft Pulp

The emission standard for adsorbable organic halogen (AOX) has been adjusted as a mandatory assessment indicator in the papermaking industrial pollutants emission standards of China. To provide a theoretical basis to reduce AOX formation, a kinetic model of the first chlorine dioxide bleaching stage (D0) is presented for elemental chlorine-free (ECF) bleaching of eucalyptus kraft pulp. The kinetics of the D0 stage can be expressed as dW/dt = 314.6e-20.53/RT[H+]0.21[ClO2]0.41K0.98, where the reaction series for lignin, chlorine dioxide dosage, and H+ concentration are 0.98, 0.41, and 0.21, respectively. The reaction activation energy was 20.53 kJ.mol-1. R2 was greater than 0.9, which means that the model was shown to have high prognostic ability and feasibility. In the D0 stage, mostly lignin was removed and the reaction was fast. Much AOX was formed at the beginning of bleaching, and the reaction rate was primarily determined by the lignin content and chlorine dioxide dosage. H+ existed primarily as a catalyst and had little influence on AOX formation. The AOX formation occurs easily, as the reaction activation energy is less than 30 kJ.mol-1.

Formulation development and systematic optimization of stabilized ziprasidone hydrochloride capsules devoid of any food effect

Context and objective: The objective of the study was to develop a stable capsule formulation of ziprasidone hydrochloride which can be administered without regards to food intake.Materials and methods: The unstable anhydrous form of ziprasidone hydrochloride was stabilized employing hot-melt extrusion and further optimized by 32 central composite design. The formulation was optimized after establishing acceptable ranges for response variables like disintegration time, dissolution and impurity profile. A crossover fasted and fed in vivo study was conducted in human volunteers to assess the food-effect of optimized formulation vis-à-vis the marketed brand.Results and discussion: The optimized formulation met in-house specifications for various response variables. Further, high values of correlation coefficient vouch the adequate selection of experimental design and its high prognostic ability. In our study, no significant difference was observed between the Cmax and AUC values after administration of the optimized formulation in fasted and fed states. On the contrary, there was a statistically significant increase in the Cmax and AUC values after oral administration of Zeldox in fed state in comparison to fasted state.Conclusions: The present study describes the successful development of a stable formulation of 20 mg of ziprasidone devoid of any food-effects.

Molecular profiling of peripheral blood is associated with circulating tumor cells content and poor survival in metastatic castration-resistant prostate cancer.

The enumeration of circulating tumor cells (CTCs) in peripheral blood correlates with clinical outcome in castration-resistant prostate cancer (CRPC). We analyzed the molecular profiling of peripheral blood from 43 metastatic CRPC patients with known CTC content in order to identify genes that may be related to prostate cancer progression. Global gene expression analysis identified the differential expression of 282 genes between samples with ≥5 CTCs vs <5 CTCs, 58.6% of which were previously described as over-expressed in prostate cancer (18.9% in primary tumors and 56.1% in metastasis). Those genes were involved in survival functions such as metabolism, signal transduction, gene expression, cell growth, death, and movement. The expression of selected genes was evaluated by quantitative RT-PCR. This analysis revealed a two-gene model (SELENBP1 and MMP9) with a high significant prognostic ability (HR 6; 95% CI 2.61 - 13.79; P<0.0001). The combination of the two-gene signature plus the CTCs count showed a higher prognostic ability than CTCs enumeration or gene expression alone (P<0.05). This study shows a gene expression profile in PBMNC associated with CTCs count and clinical outcome in metastatic CRPC, describing genes and pathways potentially associated with CRPC progression.

Development and optimization of sustained release polymeric microparticles by screening design

The aim of the present study was to investigate the effect of processing and formulation variables on polymeric microparticles, intended to be used for sustaining drug delivery of ibuprofen. Ibuprofen, polycaprolactone, dichloromethane (DCM), water, stirring speed and polyvinyl alcohol were selected as independent variables during the microparticles preparation. The independent variables influencing encapsulation efficiency (E.E.) and physical characteristics were assessed. The resultant microparticles were characterized for their E.E., surface morphology, and in vitro drug release. Ibuprofen loaded polymeric microparticles were characterized by FESEM, FTIR, DSC, and XRPD analysis. Graphical and mathematical analysis of the design showed that ibuprofen, polycaprolactone and DCM were significant effect on the E.E. of the microparticles. The low magnitudes of error and the significant values of R2 in the present investigation prove the high prognostic ability of the design. The microparticles showed high E.E. (76.11 ± 0.06–104.9 ± 0.46 %) with average particle size of 5–100 μm. The microparticles were found to be discrete, spherical with smooth surface. The FTIR analysis confirmed the compatibility of ibuprofen with the polymers. The XRPD and DSC study revealed the dispersion of drug within microparticles formulation. In vitro study showed sustain drug release over 12 h, thus prolong the drug action to treat the musculoskeletal disorder.

Optimization of sustained release aceclofenac microspheres using response surface methodology.

Polymeric microspheres containing aceclofenac were prepared by single emulsion (oil-in-water) solvent evaporation method using response surface methodology (RSM). Microspheres were prepared by changing formulation variables such as the amount of Eudragit® RS100 and the amount of polyvinyl alcohol (PVA) by statistical experimental design in order to enhance the encapsulation efficiency (E.E.) of the microspheres. The resultant microspheres were evaluated for their size, morphology, E.E., and in vitro drug release. The amount of Eudragit® RS100 and the amount of PVA were found to be significant factors respectively for determining the E.E. of the microspheres. A linear mathematical model equation fitted to the data was used to predict the E.E. in the optimal region. Optimized formulation of microspheres was prepared using optimal process variables setting in order to evaluate the optimization capability of the models generated according to IV-optimal design. The microspheres showed high E.E. (74.14±0.015% to 85.34±0.011%) and suitably sustained drug release (minimum; 40% to 60%; maximum) over a period of 12h. The optimized microspheres formulation showed E.E. of 84.87±0.005 with small error value (1.39). The low magnitudes of error and the significant value of R(2) in the present investigation prove the high prognostic ability of the design. The absence of interactions between drug and polymers was confirmed by Fourier transform infrared (FTIR) spectroscopy. Differential scanning calorimetry (DSC) and X-ray powder diffractometry (XRPD) revealed the dispersion of drug within microspheres formulation. The microspheres were found to be discrete, spherical with smooth surface. The results demonstrate that these microspheres could be promising delivery system to sustain the drug release and improve the E.E. thus prolong drug action and achieve the highest healing effect with minimal gastrointestinal side effects.

Anomalies in Network Bridges Involved in Bile Acid Metabolism Predict Outcomes of Colorectal Cancer Patients

Biomarkers prognostic for colorectal cancer (CRC) would be highly desirable in clinical practice. Proteins that regulate bile acid (BA) homeostasis, by linking metabolic sensors and metabolic enzymes, also called bridge proteins, may be reliable prognostic biomarkers for CRC. Based on a devised metric, “bridgeness,” we identified bridge proteins involved in the regulation of BA homeostasis and identified their prognostic potentials. The expression patterns of these bridge proteins could distinguish between normal and diseased tissues, suggesting that these proteins are associated with CRC pathogenesis. Using a supervised classification system, we found that these bridge proteins were reproducibly prognostic, with high prognostic ability compared to other known markers.

Study of Formulation Variables Influencing Polymeric Microparticles by Experimental Design

The objective of this study was to prepare diclofenac sodium loaded microparticles by single emulsion [oil-in-water (o/w)] solvent evaporation method. The 22 experimental design methodology was used to evaluate the effect of two formulation variables on microspheres properties using the Design-Expert® software and evaluated for their particle size, morphology, and encapsulation efficiency and in vitro drug release. The graphical and mathematical analysis of the design showed that the independent variables were a significant effect on the encapsulation efficiency and drug release of microparticles. The low magnitudes of error and significant values of R2 prove the high prognostic ability of the design. The microspheres showed high encapsulation efficiency with an increase in the amount of polymer and decrease in the amount of PVA in the formulation. The particles were found to be spherical with smooth surface. Prolonged drug release and enhancement of encapsulation efficiency of polymeric microparticles can be successfully obtained with an application of experimental design technique.

Aceclofenac microspheres: Quality by design approach

The purpose of this study was to prepare polymeric microspheres containing aceclofenac by single emulsion [oil-in-water (o/w)] solvent evaporation method. Two biocompatible polymers, ethylcellulose, and Eudragit® RS100 were used in combination. Seven processing factors were investigated by Plackett–Burman design (PBD) in order to enhance the encapsulation efficiency of the microspheres. A Plackett–Burman design was employed by using the Design-Expert® software (Version-8.0.7.1). The resultant microspheres were characterized for their size, morphology, encapsulation efficiency, and drug release. Imaging of particles was performed by field emission scanning electron microscopy. Interaction between the drug and polymers were investigated by Fourier transform infrared (FTIR) spectroscopy, and X-ray powder diffractometry (XRPD). Graphical and mathematical analyses of the design showed that Eudragit® RS100, and polyvinyl alcohol (PVA) were significant negative effect on the encapsulation efficiency and identified as the significant factor determining the encapsulation efficiency of the microspheres. The low magnitudes of error and the significant values of R2 in the present investigation prove the high prognostic ability of the design. The microspheres showed high encapsulation efficiency (70.15% to 83.82%). The microspheres were found to be discrete, oval with smooth surface. The FTIR analysis confirmed the compatibility of aceclofenac with the polymers. The XRPD revealed the dispersion of drug within microspheres formulation. Perfect prolonged drug release profile over 12h was achieved by a combination of ethylcellulose, and Eudragit® RS100 polymers. In conclusion, polymeric microspheres containing aceclofenac can be successfully prepared using the technique of experimental design, and these results helped in finding the optimum formulation variables for encapsulation efficiency of microspheres.

The impact of manufacturing variables on in vitro release of clobetasol 17-propionate from pilot scale cream formulations

Objectives: The purpose of the study was to evaluate the effect of different homogenization speeds and times, anchor speeds and cooling times on the viscosity and cumulative % clobetasol 17-propionate released per unit area at 72 h from pilot scale cream formulations. A 24 full factorial central composite design for four independent variables were investigated.Materials and methods: Thirty pilot scale batches of cream formulations were manufactured using a Wintech® cream/ointment plant. The viscosity and in vitro release of CP were monitored and compared to an innovator product that is commercially available on the South African market, namely, Dermovate® cream.Results and discussion: Contour and three-dimensional response surface plots were produced and the viscosity and cumulative % CP released per unit area at 72 h were found to be primarily dependent on the homogenization and anchor speeds. An increase in the homogenization and anchor speeds appeared to exhibit a synergistic effect on the resultant viscosity of the cream whereas an antagonistic effect was observed for the in vitro release of CP from the experimental cream formulations. The in vitro release profiles were best fitted to a Higuchi model and diffusion proved to be the dominant mechanism of drug release that was confirmed by use of the Korsmeyer–Peppas model.Conclusion: The research was further validated and confirmed by the high prognostic ability of response surface methodology (RSM) with a resultant mean percentage error of (±SD) 0.17 ± 0.093 suggesting that RSM may be an efficient tool for the development and optimization of topical formulations.

240 PREDICTING PROSTATE SPECIFIC ANTIGEN RECURRENCE AFTER RADICAL PROSTATECTOMY BY CLINICOPATHOLOGICAL FACTORS: SUITABILITY OF MAGNETIC RESONANCE IMAGING

You have accessJournal of UrologyProstate Cancer: Staging (I)1 Apr 2013240 PREDICTING PROSTATE SPECIFIC ANTIGEN RECURRENCE AFTER RADICAL PROSTATECTOMY BY CLINICOPATHOLOGICAL FACTORS: SUITABILITY OF MAGNETIC RESONANCE IMAGING Seiya Hattori, Takeo Kosaka, Ryuichi Mizuno, Yota Yasumizu, Akira Miyajima, Hirohiko Nagata, Satoshi Yazawa, Eiji Kikuchi, Ken Nakagawa, Shuji Mikami, Akihiro Tanimoto, Masahiro Jinzaki, and Mototsugu Oya Seiya HattoriSeiya Hattori Tokyo, Japan More articles by this author , Takeo KosakaTakeo Kosaka Tokyo, Japan More articles by this author , Ryuichi MizunoRyuichi Mizuno Tokyo, Japan More articles by this author , Yota YasumizuYota Yasumizu Tokyo, Japan More articles by this author , Akira MiyajimaAkira Miyajima Tokyo, Japan More articles by this author , Hirohiko NagataHirohiko Nagata Tokyo, Japan More articles by this author , Satoshi YazawaSatoshi Yazawa Tokyo, Japan More articles by this author , Eiji KikuchiEiji Kikuchi Tokyo, Japan More articles by this author , Ken NakagawaKen Nakagawa Tokyo, Japan More articles by this author , Shuji MikamiShuji Mikami Tokyo, Japan More articles by this author , Akihiro TanimotoAkihiro Tanimoto Tokyo, Japan More articles by this author , Masahiro JinzakiMasahiro Jinzaki Tokyo, Japan More articles by this author , and Mototsugu OyaMototsugu Oya Tokyo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1620AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Magnetic resonance imaging (MRI) has been increasingly used to assess the size, location, and pathological features of prostate cancer. However, its prognostic significance has not been fully characterized. The purpose of this study is to retrospectively evaluate the suitability of preoperative MRI-visibility in indicating PSA recurrence after radical prostatectomy. METHODS We reviewed the clinical records of 621 patients who underwent radical prostatectomy (n=156) or laparoscopic radical prostatectomy (n=465) between July 1997 and December 2009 at our institution. All patients underwent preoperative MRI. Cox proportional hazard regression models were used for univariate and multivariate analyses to test the relationships between biochemical failure and pathological factors. RESULTS Pathologically, in 382 patients (61.5%) the disease was confined to the prostate (pT2) and in 239 (38.5%) it was extraprostatic (pT3). Univariate analysis revealed MRI-visibility and the other clinicopathological parameters, including PSA level≥10 ng/mL, clinical T stage (DRE), biopsy Gleason score (GS)≥8, pathological GS≥8, positive core rate >0.2, and PSM were significantly associated with biochemical failure. Multivariate analysis revealed MRI-visibility was a prognostic indicator. Using PSA level, MRI-visibility, pathological GS≥8, and PSM, we developed a prognostic factor-based model for risk stratification. MRI-visibility was statistically related to high clinical stage (cT≥2), high positive core rate (≥0.2), and high biopsy/pathological GS (≥8). Stratified analysis with respect to age, PSA level, and biopsy GS suggested high prognostic predictive ability in patients with low PSA level (<10), low biopsy GS≤, and age ≤70 yr. CONCLUSIONS MRI-visibility can independently predict PSA recurrence after radical prostatectomy, particularly in younger patients with low PSA level and low biopsy GS. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e99 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Seiya Hattori Tokyo, Japan More articles by this author Takeo Kosaka Tokyo, Japan More articles by this author Ryuichi Mizuno Tokyo, Japan More articles by this author Yota Yasumizu Tokyo, Japan More articles by this author Akira Miyajima Tokyo, Japan More articles by this author Hirohiko Nagata Tokyo, Japan More articles by this author Satoshi Yazawa Tokyo, Japan More articles by this author Eiji Kikuchi Tokyo, Japan More articles by this author Ken Nakagawa Tokyo, Japan More articles by this author Shuji Mikami Tokyo, Japan More articles by this author Akihiro Tanimoto Tokyo, Japan More articles by this author Masahiro Jinzaki Tokyo, Japan More articles by this author Mototsugu Oya Tokyo, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...