Clinical significance of multiparametric MRI and PSA density as predictors of residual tumor (pT0) following radical prostatectomy for T1a-T1b (incidental) prostate cancer.

<h4>Purpose</h4>The aim of this study was to evaluate predictors of residual tumor and clinical prognosis in T1a-T1b (incidental) prostate cancer by analysis of specimens from men undergoing surgery for benign prostatic hyperplasia.<h4>Materials and methods</h4>We retrospecti...

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Autores principales:	Doo Yong Chung, Hyeok Jun Goh, Dong Hoon Koh, Min Seok Kim, Jong Soo Lee, Won Sik Jang, Young Deuk Choi
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2018
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/88ccb98dd05c4e6eb71831ce651c3018
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spelling	oai:doaj.org-article:88ccb98dd05c4e6eb71831ce651c30182021-12-02T20:15:53ZClinical significance of multiparametric MRI and PSA density as predictors of residual tumor (pT0) following radical prostatectomy for T1a-T1b (incidental) prostate cancer.1932-620310.1371/journal.pone.0210037https://doaj.org/article/88ccb98dd05c4e6eb71831ce651c30182018-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0210037https://doaj.org/toc/1932-6203<h4>Purpose</h4>The aim of this study was to evaluate predictors of residual tumor and clinical prognosis in T1a-T1b (incidental) prostate cancer by analysis of specimens from men undergoing surgery for benign prostatic hyperplasia.<h4>Materials and methods</h4>We retrospectively reviewed medical records of incidental prostate cancer patients who had undergone radical prostatectomy. Patients whose tumor statuses were further confirmed by prostate biopsy, or who had used androgen deprivation therapy before radical prostatectomy, were excluded. Clinical and pathological parameters were analyzed to evaluate residual tumor and clinical prognosis. We used univariate and multivariate logistic regression analyses, as well as receiver operator characteristics, to predict residual tumor (pT0).<h4>Results</h4>The final analysis included 95 patients. Among these patients, 67 (70.53%) exhibited residual tumor, whereas 28 (29.47%) did not (pT0). Pathology findings showed that 44 (65.67%), 16 (23.88%), and 7 patients (10.45%) exhibited Gleason scores of G6, G7, and ≥G8, respectively. Fifty-seven and 10 patients exhibited pathologic T stages T2 and T3, respectively. Mean follow-up duration was 70.26 (±34.67) months. Biochemical recurrence was observed in 11 patients; none were pT0 patients. Multivariate logistic regression showed that low prostate-specific antigen density after benign prostatic hyperplasia surgery and invisible lesion on multiparametric magnetic resonance imaging were significantly associated with pT0. Additionally, a combination of these factors showed an increase in the diagnostic accuracy of pT0, compared with mpMRI alone (AUC 0.805, 0.767, respectively); this combination showed sensitivity, specificity, and positive predictive values of 71.6%, 89.3%, and 94.1%, respectively.<h4>Conclusion</h4>Our results suggest that patients with incidental prostate cancer who have both prostate-specific antigen density ≤0.08 after benign prostatic hyperplasia surgery as well as invisible cancer lesion on multiparametric magnetic resonance imaging should be considered for active surveillance.Doo Yong ChungHyeok Jun GohDong Hoon KohMin Seok KimJong Soo LeeWon Sik JangYoung Deuk ChoiPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 13, Iss 12, p e0210037 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Doo Yong Chung Hyeok Jun Goh Dong Hoon Koh Min Seok Kim Jong Soo Lee Won Sik Jang Young Deuk Choi Clinical significance of multiparametric MRI and PSA density as predictors of residual tumor (pT0) following radical prostatectomy for T1a-T1b (incidental) prostate cancer.
description	<h4>Purpose</h4>The aim of this study was to evaluate predictors of residual tumor and clinical prognosis in T1a-T1b (incidental) prostate cancer by analysis of specimens from men undergoing surgery for benign prostatic hyperplasia.<h4>Materials and methods</h4>We retrospectively reviewed medical records of incidental prostate cancer patients who had undergone radical prostatectomy. Patients whose tumor statuses were further confirmed by prostate biopsy, or who had used androgen deprivation therapy before radical prostatectomy, were excluded. Clinical and pathological parameters were analyzed to evaluate residual tumor and clinical prognosis. We used univariate and multivariate logistic regression analyses, as well as receiver operator characteristics, to predict residual tumor (pT0).<h4>Results</h4>The final analysis included 95 patients. Among these patients, 67 (70.53%) exhibited residual tumor, whereas 28 (29.47%) did not (pT0). Pathology findings showed that 44 (65.67%), 16 (23.88%), and 7 patients (10.45%) exhibited Gleason scores of G6, G7, and ≥G8, respectively. Fifty-seven and 10 patients exhibited pathologic T stages T2 and T3, respectively. Mean follow-up duration was 70.26 (±34.67) months. Biochemical recurrence was observed in 11 patients; none were pT0 patients. Multivariate logistic regression showed that low prostate-specific antigen density after benign prostatic hyperplasia surgery and invisible lesion on multiparametric magnetic resonance imaging were significantly associated with pT0. Additionally, a combination of these factors showed an increase in the diagnostic accuracy of pT0, compared with mpMRI alone (AUC 0.805, 0.767, respectively); this combination showed sensitivity, specificity, and positive predictive values of 71.6%, 89.3%, and 94.1%, respectively.<h4>Conclusion</h4>Our results suggest that patients with incidental prostate cancer who have both prostate-specific antigen density ≤0.08 after benign prostatic hyperplasia surgery as well as invisible cancer lesion on multiparametric magnetic resonance imaging should be considered for active surveillance.
format	article
author	Doo Yong Chung Hyeok Jun Goh Dong Hoon Koh Min Seok Kim Jong Soo Lee Won Sik Jang Young Deuk Choi
author_facet	Doo Yong Chung Hyeok Jun Goh Dong Hoon Koh Min Seok Kim Jong Soo Lee Won Sik Jang Young Deuk Choi
author_sort	Doo Yong Chung
title	Clinical significance of multiparametric MRI and PSA density as predictors of residual tumor (pT0) following radical prostatectomy for T1a-T1b (incidental) prostate cancer.
title_short	Clinical significance of multiparametric MRI and PSA density as predictors of residual tumor (pT0) following radical prostatectomy for T1a-T1b (incidental) prostate cancer.
title_full	Clinical significance of multiparametric MRI and PSA density as predictors of residual tumor (pT0) following radical prostatectomy for T1a-T1b (incidental) prostate cancer.
title_fullStr	Clinical significance of multiparametric MRI and PSA density as predictors of residual tumor (pT0) following radical prostatectomy for T1a-T1b (incidental) prostate cancer.
title_full_unstemmed	Clinical significance of multiparametric MRI and PSA density as predictors of residual tumor (pT0) following radical prostatectomy for T1a-T1b (incidental) prostate cancer.
title_sort	clinical significance of multiparametric mri and psa density as predictors of residual tumor (pt0) following radical prostatectomy for t1a-t1b (incidental) prostate cancer.
publisher	Public Library of Science (PLoS)
publishDate	2018
url	https://doaj.org/article/88ccb98dd05c4e6eb71831ce651c3018
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Clinical significance of multiparametric MRI and PSA density as predictors of residual tumor (pT0) following radical prostatectomy for T1a-T1b (incidental) prostate cancer.

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