Is suspicious upstaging on multiparametric magnetic resonance imaging useful in improving the reliability of Prostate Cancer Research International Active Surveillance (PRIAS) criteria? Use of the K-CaP registry

Sangjun Yoo, Jun Hyuk Hong, Seok Soo Byun, Ji Youl Lee, Byungha Chung, Choung Soo Kim

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Abstract

Background and objective To evaluate the clinical effects of suspicious upstaging on multiparametric magnetic resonance imaging (mpMRI) for improving the quality of Prostate Cancer Research International Active Surveillance (PRIAS) criteria. Material and methods A total of 363 patients with low-risk prostate cancer (PCa) were selected from the K-CaP registry (the multicenter Korean PCa Database). Patients were divided into 2 groups according to the results of mpMRI (with or without suspicious upstaging). The variables for predicting significant PCa, defined as locally advanced PCa, Gleason score≥7, or tumor volume>0.5 cc or all of these, and adverse PCa, defined as locally advanced PCa, Gleason score≥7 (4+3), or tumor volume>2.5 cc or all of these, were assessed. Results The mpMRI led to “suspicious” upstaging in 56 patients (15.4%). Significant PCa (98.2% vs. 74.6%, P<0.001) and adverse PCa (85.7% vs. 32.6%, P<0.001) were more common in patients with suspicious upstaging. The sensitivity/specificity of mpMRI for significant PCa and adverse PCa were 25.4%/98.2% and 32.4%/96.3%, respectively. On multivariate analyses, suspicious upstaging on mpMRI (odds ratio: 15.82, P = 0.007) was a predictor for significant PCa in addition to PRIAS criteria and age at diagnosis. In addition, suspicious upstaging on mpMRI (odds ratio: 11.11, P<0.001) was a significant predictor for adverse PCa in addition to PRIAS criteria, age at diagnosis, and body mass index. Conclusion Along with the PRIAS criteria, suspicious upstaging on mpMRI is a potent diagnostic tool for distinguishing patients suitable for active surveillance among patients with low-risk PCa.

Original languageEnglish
Pages (from-to)459.e7-459.e13
JournalUrologic Oncology: Seminars and Original Investigations
Volume35
Issue number7
DOIs
Publication statusPublished - 2017 Jul 1

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Registries
Prostatic Neoplasms
Magnetic Resonance Imaging
Research
Tumor Burden
Odds Ratio
Body Mass Index

All Science Journal Classification (ASJC) codes

  • Oncology
  • Urology

Cite this

@article{b1833a57da4f46c29159779046e9bb41,
title = "Is suspicious upstaging on multiparametric magnetic resonance imaging useful in improving the reliability of Prostate Cancer Research International Active Surveillance (PRIAS) criteria? Use of the K-CaP registry",
abstract = "Background and objective To evaluate the clinical effects of suspicious upstaging on multiparametric magnetic resonance imaging (mpMRI) for improving the quality of Prostate Cancer Research International Active Surveillance (PRIAS) criteria. Material and methods A total of 363 patients with low-risk prostate cancer (PCa) were selected from the K-CaP registry (the multicenter Korean PCa Database). Patients were divided into 2 groups according to the results of mpMRI (with or without suspicious upstaging). The variables for predicting significant PCa, defined as locally advanced PCa, Gleason score≥7, or tumor volume>0.5 cc or all of these, and adverse PCa, defined as locally advanced PCa, Gleason score≥7 (4+3), or tumor volume>2.5 cc or all of these, were assessed. Results The mpMRI led to “suspicious” upstaging in 56 patients (15.4{\%}). Significant PCa (98.2{\%} vs. 74.6{\%}, P<0.001) and adverse PCa (85.7{\%} vs. 32.6{\%}, P<0.001) were more common in patients with suspicious upstaging. The sensitivity/specificity of mpMRI for significant PCa and adverse PCa were 25.4{\%}/98.2{\%} and 32.4{\%}/96.3{\%}, respectively. On multivariate analyses, suspicious upstaging on mpMRI (odds ratio: 15.82, P = 0.007) was a predictor for significant PCa in addition to PRIAS criteria and age at diagnosis. In addition, suspicious upstaging on mpMRI (odds ratio: 11.11, P<0.001) was a significant predictor for adverse PCa in addition to PRIAS criteria, age at diagnosis, and body mass index. Conclusion Along with the PRIAS criteria, suspicious upstaging on mpMRI is a potent diagnostic tool for distinguishing patients suitable for active surveillance among patients with low-risk PCa.",
author = "Sangjun Yoo and Hong, {Jun Hyuk} and Byun, {Seok Soo} and Lee, {Ji Youl} and Byungha Chung and Kim, {Choung Soo}",
year = "2017",
month = "7",
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doi = "10.1016/j.urolonc.2016.07.014",
language = "English",
volume = "35",
pages = "459.e7--459.e13",
journal = "Urologic Oncology",
issn = "1078-1439",
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TY - JOUR

T1 - Is suspicious upstaging on multiparametric magnetic resonance imaging useful in improving the reliability of Prostate Cancer Research International Active Surveillance (PRIAS) criteria? Use of the K-CaP registry

AU - Yoo, Sangjun

AU - Hong, Jun Hyuk

AU - Byun, Seok Soo

AU - Lee, Ji Youl

AU - Chung, Byungha

AU - Kim, Choung Soo

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Background and objective To evaluate the clinical effects of suspicious upstaging on multiparametric magnetic resonance imaging (mpMRI) for improving the quality of Prostate Cancer Research International Active Surveillance (PRIAS) criteria. Material and methods A total of 363 patients with low-risk prostate cancer (PCa) were selected from the K-CaP registry (the multicenter Korean PCa Database). Patients were divided into 2 groups according to the results of mpMRI (with or without suspicious upstaging). The variables for predicting significant PCa, defined as locally advanced PCa, Gleason score≥7, or tumor volume>0.5 cc or all of these, and adverse PCa, defined as locally advanced PCa, Gleason score≥7 (4+3), or tumor volume>2.5 cc or all of these, were assessed. Results The mpMRI led to “suspicious” upstaging in 56 patients (15.4%). Significant PCa (98.2% vs. 74.6%, P<0.001) and adverse PCa (85.7% vs. 32.6%, P<0.001) were more common in patients with suspicious upstaging. The sensitivity/specificity of mpMRI for significant PCa and adverse PCa were 25.4%/98.2% and 32.4%/96.3%, respectively. On multivariate analyses, suspicious upstaging on mpMRI (odds ratio: 15.82, P = 0.007) was a predictor for significant PCa in addition to PRIAS criteria and age at diagnosis. In addition, suspicious upstaging on mpMRI (odds ratio: 11.11, P<0.001) was a significant predictor for adverse PCa in addition to PRIAS criteria, age at diagnosis, and body mass index. Conclusion Along with the PRIAS criteria, suspicious upstaging on mpMRI is a potent diagnostic tool for distinguishing patients suitable for active surveillance among patients with low-risk PCa.

AB - Background and objective To evaluate the clinical effects of suspicious upstaging on multiparametric magnetic resonance imaging (mpMRI) for improving the quality of Prostate Cancer Research International Active Surveillance (PRIAS) criteria. Material and methods A total of 363 patients with low-risk prostate cancer (PCa) were selected from the K-CaP registry (the multicenter Korean PCa Database). Patients were divided into 2 groups according to the results of mpMRI (with or without suspicious upstaging). The variables for predicting significant PCa, defined as locally advanced PCa, Gleason score≥7, or tumor volume>0.5 cc or all of these, and adverse PCa, defined as locally advanced PCa, Gleason score≥7 (4+3), or tumor volume>2.5 cc or all of these, were assessed. Results The mpMRI led to “suspicious” upstaging in 56 patients (15.4%). Significant PCa (98.2% vs. 74.6%, P<0.001) and adverse PCa (85.7% vs. 32.6%, P<0.001) were more common in patients with suspicious upstaging. The sensitivity/specificity of mpMRI for significant PCa and adverse PCa were 25.4%/98.2% and 32.4%/96.3%, respectively. On multivariate analyses, suspicious upstaging on mpMRI (odds ratio: 15.82, P = 0.007) was a predictor for significant PCa in addition to PRIAS criteria and age at diagnosis. In addition, suspicious upstaging on mpMRI (odds ratio: 11.11, P<0.001) was a significant predictor for adverse PCa in addition to PRIAS criteria, age at diagnosis, and body mass index. Conclusion Along with the PRIAS criteria, suspicious upstaging on mpMRI is a potent diagnostic tool for distinguishing patients suitable for active surveillance among patients with low-risk PCa.

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U2 - 10.1016/j.urolonc.2016.07.014

DO - 10.1016/j.urolonc.2016.07.014

M3 - Article

VL - 35

SP - 459.e7-459.e13

JO - Urologic Oncology

JF - Urologic Oncology

SN - 1078-1439

IS - 7

ER -