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Current Oncology
Volume 29
Issue 4
10.3390/curroncol29040193
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Article

Concordance between Preoperative mpMRI and Pathological Stage and Its Influence on Nerve-Sparing Surgery in Patients with High-Risk Prostate Cancer

by
Clara Humke
1,*,†,
Benedikt Hoeh
1,2,*,†,
Felix Preisser
1,
Mike Wenzel
1,
Maria N. Welte
1,
Lena Theissen
1,
Boris Bodelle
3,
Jens Koellermann
4,
Thomas Steuber
5,
Alexander Haese
5,
Frederik Roos
1,
Luis Alex Kluth
1,
Andreas Becker
1,
Felix K. H. Chun
1 and
Philipp Mandel
1
1
Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60590 Frankfurt, Germany
2
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H4A 3J1, Canada
3
Department of Radiology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60590 Frankfurt, Germany
4
Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, 60590 Frankfurt, Germany
5
Martini-Clinic Prostate Cancer Center, University Hospital Hamburg-Eppendorf, 20251 Hamburg, Germany
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Curr. Oncol. 2022, 29(4), 2385-2394; https://doi.org/10.3390/curroncol29040193
Submission received: 27 February 2022 / Revised: 22 March 2022 / Accepted: 25 March 2022 / Published: 28 March 2022
(This article belongs to the Special Issue Surgery for Prostate Cancer: Recent Advances and Future Directions)
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Abstract

Background: We aimed to determine the concordance between the radiologic stage (rT), using multiparametric magnetic resonance imaging (mpMRI), and pathologic stage (pT) in patients with high-risk prostate cancer and its influence on nerve-sparing surgery compared to the use of the intraoperative frozen section technique (IFST). Methods: The concordance between rT and pT and the rates of nerve-sparing surgery and positive surgical margin were assessed for patients with high-risk prostate cancer who underwent radical prostatectomy. Results: The concordance between the rT and pT stages was shown in 66.4% (n = 77) of patients with clinical high-risk prostate cancer. The detection of patients with extraprostatic disease (≥pT3) by preoperative mpMRI showed a sensitivity, negative predictive value and accuracy of 65.1%, 51.7% and 67.5%. In addition to the suspicion of extraprostatic disease in mpMRI (≥rT3), 84.5% (n = 56) of patients with ≥rT3 underwent primary nerve-sparing surgery with IFST, resulting in 94.7% (n = 54) of men with at least unilateral nerve-sparing surgery after secondary resection with a positive surgical margin rate related to an IFST of 1.8% (n = 1). Conclusion: Patients with rT3 should not be immediately excluded from nerve-sparing surgery, as by using IFST some of these patients can safely undergo nerve-sparing surgery.
Keywords: prostate cancer; nerve-sparing surgery; radical prostatectomy; multiparametric magnetic resonance imaging prostate cancer; nerve-sparing surgery; radical prostatectomy; multiparametric magnetic resonance imaging

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MDPI and ACS Style

Humke, C.; Hoeh, B.; Preisser, F.; Wenzel, M.; Welte, M.N.; Theissen, L.; Bodelle, B.; Koellermann, J.; Steuber, T.; Haese, A.; et al. Concordance between Preoperative mpMRI and Pathological Stage and Its Influence on Nerve-Sparing Surgery in Patients with High-Risk Prostate Cancer. Curr. Oncol. 2022, 29, 2385-2394. https://doi.org/10.3390/curroncol29040193

AMA Style

Humke C, Hoeh B, Preisser F, Wenzel M, Welte MN, Theissen L, Bodelle B, Koellermann J, Steuber T, Haese A, et al. Concordance between Preoperative mpMRI and Pathological Stage and Its Influence on Nerve-Sparing Surgery in Patients with High-Risk Prostate Cancer. Current Oncology. 2022; 29(4):2385-2394. https://doi.org/10.3390/curroncol29040193

Chicago/Turabian Style

Humke, Clara, Benedikt Hoeh, Felix Preisser, Mike Wenzel, Maria N. Welte, Lena Theissen, Boris Bodelle, Jens Koellermann, Thomas Steuber, Alexander Haese, and et al. 2022. "Concordance between Preoperative mpMRI and Pathological Stage and Its Influence on Nerve-Sparing Surgery in Patients with High-Risk Prostate Cancer" Current Oncology 29, no. 4: 2385-2394. https://doi.org/10.3390/curroncol29040193

APA Style

Humke, C., Hoeh, B., Preisser, F., Wenzel, M., Welte, M. N., Theissen, L., Bodelle, B., Koellermann, J., Steuber, T., Haese, A., Roos, F., Kluth, L. A., Becker, A., Chun, F. K. H., & Mandel, P. (2022). Concordance between Preoperative mpMRI and Pathological Stage and Its Influence on Nerve-Sparing Surgery in Patients with High-Risk Prostate Cancer. Current Oncology, 29(4), 2385-2394. https://doi.org/10.3390/curroncol29040193

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