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Clinical Significance of Multiparametric Magnetic Resonance Imaging as a Preoperative Predictor of Oncologic Outcome in Very Low-Risk Prostate Cancer

1
Department of Urology, Inha University School of Medicine, 366 Seohae-daero, Jung-gu, Incheon 22332, Korea
2
Department of Urology, Urological Science Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea
3
Department of Urology, Konyang University College of Medicine, 158 Gwanjeodong-ro, Daejeon 35365, Korea
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(4), 542; https://doi.org/10.3390/jcm8040542
Received: 22 March 2019 / Revised: 10 April 2019 / Accepted: 18 April 2019 / Published: 19 April 2019
(This article belongs to the Section Nuclear Medicine & Radiology)
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Abstract

Currently, multiparametric magnetic resonance imaging (mpMRI) is not an indication for patients with very low-risk prostate cancer. In this study, we aimed to evaluate the usefulness of mpMRI as a diagnostic tool in these patients. We retrospectively analyzed the clinical and pathological data of individuals with very low-risk prostate cancer, according to the NCCN guidelines, who underwent mpMRI before radical prostatectomy at our institution between 2010 and 2016. Patients who did not undergo pre-evaluation with mpMRI were excluded. We analyzed the factors associated with biochemical recurrence (BCR) using Cox regression model, logistic regression analysis, and Kaplan–Meier curve. Of 253 very low-risk prostate cancer patients, we observed 26 (10.3%) with BCR during the follow-up period in this study. The median follow-up from radical prostatectomy was 53 months (IQR 33–74). The multivariate Cox regression analyses demonstrated that the only factor associated with BCR in very low-risk patients was increase in the pathologic Gleason score (GS) (HR: 2.185, p-value 0.048). In addition, multivariate logistic analyses identified prostate specific antigen (PSA) (OR: 1.353, p-value 0.010), PSA density (OR: 1.160, p-value 0.013), and suspicious lesion on mpMRI (OR: 1.995, p-value 0.019) as the independent preoperative predictors associated with the pathologic GS upgrade. In our study, the pathologic GS upgrade after radical prostatectomy in very low-risk prostate cancer patients demonstrated a negative impact on BCR and mpMRI is a good prognostic tool to predict the pathologic GS upgrade. We believe that the implementation of mpMRI would be beneficial to determine the treatment strategy for these patients. View Full-Text
Keywords: multiparametric MRI; preoperative predictor; oncologic outcome; very low-risk prostate cancer multiparametric MRI; preoperative predictor; oncologic outcome; very low-risk prostate cancer
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Chung, D.Y.; Kim, M.S.; Lee, J.S.; Goh, H.J.; Koh, D.H.; Jang, W.S.; Hong, C.H.; Choi, Y.D. Clinical Significance of Multiparametric Magnetic Resonance Imaging as a Preoperative Predictor of Oncologic Outcome in Very Low-Risk Prostate Cancer. J. Clin. Med. 2019, 8, 542.

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