Low-risk prostate cancer patients without visible tumor (T1c) on multiparametric MRI could qualify for active surveillance candidate even if they did not meet inclusion criteria of active surveillance protocol

Dong Hoon Lee, Kyo Chul Koo, Seung Hwan Lee, KoonHo Rha, Youngdeuk Choi, Sung Joon Hong, Byungha Chung

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Abstract

Introduction:We compared the pathologic outcomes of prostate cancer patients who did not qualify for active surveillance according to the tumor visibility on multiparametric magnetic resonance imaging. Material and methods: We retrospectively analyzed 464 prostate cancer patients who underwent multiparametric magnetic resonance imaging before radical prostatectomy between 2006 and 2012. All the patients had clinically localized prostate cancer with Gleason score ≤6 and prostate-specific antigen ≤10 ng/ml. Of these patients, 238 were eligible for active surveillance (group A) and 226 were not. We divided these 226 patients into two groups according to the result of multiparametric magnetic resonance imaging: 59 (26.1%) patients without visible tumor (group B) and 167 (73.9%) patients with visible tumor (group C). We evaluated the pathologic outcomes of organ-confined Gleason ≤6 disease and unfavorable disease in each group. Results: The proportions of organ-confined Gleason ≤6 disease and unfavorable disease were 63.9 and 11.3% in group A, 59.3 and 10.2% in group B, and 38.9 and 22.8% in Group C. Comparing group A and B, these proportions were not statistically different (P = 0.549 and P = 1.000, respectively). However, comparing group A and C, those were significantly different (P< 0.001 and P = 0.002, respectively). In multivariate logistic regression analysis, no visible tumor on multiparametric magnetic resonance imaging was an independent predictor of organ-confined Gleason score 6 disease (odds ratio 0.426, P = 0.007) but there was no statistically independent predictor for unfavorable disease. Conclusions: The tumor visibility on multiparametric magnetic resonance imaging could be a predictor of favorable disease for the prostate cancer patients who did not meet active surveillance criteria. Multiparametric magnetic resonance imaging could help to determine treatment modality for the low-risk prostate cancer patients who consider active surveillance even if they did not meet active surveillance criteria.

Original languageEnglish
Pages (from-to)553-558
Number of pages6
JournalJapanese Journal of Clinical Oncology
Volume43
Issue number5
DOIs
Publication statusPublished - 2013 May 1

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Prostatic Neoplasms
Magnetic Resonance Imaging
Neoplasms
Neoplasm Grading
Prostate-Specific Antigen
Prostatectomy
Logistic Models
Odds Ratio
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

@article{0e39246af2bd4215b36802e806405e46,
title = "Low-risk prostate cancer patients without visible tumor (T1c) on multiparametric MRI could qualify for active surveillance candidate even if they did not meet inclusion criteria of active surveillance protocol",
abstract = "Introduction:We compared the pathologic outcomes of prostate cancer patients who did not qualify for active surveillance according to the tumor visibility on multiparametric magnetic resonance imaging. Material and methods: We retrospectively analyzed 464 prostate cancer patients who underwent multiparametric magnetic resonance imaging before radical prostatectomy between 2006 and 2012. All the patients had clinically localized prostate cancer with Gleason score ≤6 and prostate-specific antigen ≤10 ng/ml. Of these patients, 238 were eligible for active surveillance (group A) and 226 were not. We divided these 226 patients into two groups according to the result of multiparametric magnetic resonance imaging: 59 (26.1{\%}) patients without visible tumor (group B) and 167 (73.9{\%}) patients with visible tumor (group C). We evaluated the pathologic outcomes of organ-confined Gleason ≤6 disease and unfavorable disease in each group. Results: The proportions of organ-confined Gleason ≤6 disease and unfavorable disease were 63.9 and 11.3{\%} in group A, 59.3 and 10.2{\%} in group B, and 38.9 and 22.8{\%} in Group C. Comparing group A and B, these proportions were not statistically different (P = 0.549 and P = 1.000, respectively). However, comparing group A and C, those were significantly different (P< 0.001 and P = 0.002, respectively). In multivariate logistic regression analysis, no visible tumor on multiparametric magnetic resonance imaging was an independent predictor of organ-confined Gleason score 6 disease (odds ratio 0.426, P = 0.007) but there was no statistically independent predictor for unfavorable disease. Conclusions: The tumor visibility on multiparametric magnetic resonance imaging could be a predictor of favorable disease for the prostate cancer patients who did not meet active surveillance criteria. Multiparametric magnetic resonance imaging could help to determine treatment modality for the low-risk prostate cancer patients who consider active surveillance even if they did not meet active surveillance criteria.",
author = "Lee, {Dong Hoon} and Koo, {Kyo Chul} and Lee, {Seung Hwan} and KoonHo Rha and Youngdeuk Choi and Hong, {Sung Joon} and Byungha Chung",
year = "2013",
month = "5",
day = "1",
doi = "10.1093/jjco/hyt041",
language = "English",
volume = "43",
pages = "553--558",
journal = "Japanese Journal of Clinical Oncology",
issn = "0368-2811",
publisher = "Oxford University Press",
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TY - JOUR

T1 - Low-risk prostate cancer patients without visible tumor (T1c) on multiparametric MRI could qualify for active surveillance candidate even if they did not meet inclusion criteria of active surveillance protocol

AU - Lee, Dong Hoon

AU - Koo, Kyo Chul

AU - Lee, Seung Hwan

AU - Rha, KoonHo

AU - Choi, Youngdeuk

AU - Hong, Sung Joon

AU - Chung, Byungha

PY - 2013/5/1

Y1 - 2013/5/1

N2 - Introduction:We compared the pathologic outcomes of prostate cancer patients who did not qualify for active surveillance according to the tumor visibility on multiparametric magnetic resonance imaging. Material and methods: We retrospectively analyzed 464 prostate cancer patients who underwent multiparametric magnetic resonance imaging before radical prostatectomy between 2006 and 2012. All the patients had clinically localized prostate cancer with Gleason score ≤6 and prostate-specific antigen ≤10 ng/ml. Of these patients, 238 were eligible for active surveillance (group A) and 226 were not. We divided these 226 patients into two groups according to the result of multiparametric magnetic resonance imaging: 59 (26.1%) patients without visible tumor (group B) and 167 (73.9%) patients with visible tumor (group C). We evaluated the pathologic outcomes of organ-confined Gleason ≤6 disease and unfavorable disease in each group. Results: The proportions of organ-confined Gleason ≤6 disease and unfavorable disease were 63.9 and 11.3% in group A, 59.3 and 10.2% in group B, and 38.9 and 22.8% in Group C. Comparing group A and B, these proportions were not statistically different (P = 0.549 and P = 1.000, respectively). However, comparing group A and C, those were significantly different (P< 0.001 and P = 0.002, respectively). In multivariate logistic regression analysis, no visible tumor on multiparametric magnetic resonance imaging was an independent predictor of organ-confined Gleason score 6 disease (odds ratio 0.426, P = 0.007) but there was no statistically independent predictor for unfavorable disease. Conclusions: The tumor visibility on multiparametric magnetic resonance imaging could be a predictor of favorable disease for the prostate cancer patients who did not meet active surveillance criteria. Multiparametric magnetic resonance imaging could help to determine treatment modality for the low-risk prostate cancer patients who consider active surveillance even if they did not meet active surveillance criteria.

AB - Introduction:We compared the pathologic outcomes of prostate cancer patients who did not qualify for active surveillance according to the tumor visibility on multiparametric magnetic resonance imaging. Material and methods: We retrospectively analyzed 464 prostate cancer patients who underwent multiparametric magnetic resonance imaging before radical prostatectomy between 2006 and 2012. All the patients had clinically localized prostate cancer with Gleason score ≤6 and prostate-specific antigen ≤10 ng/ml. Of these patients, 238 were eligible for active surveillance (group A) and 226 were not. We divided these 226 patients into two groups according to the result of multiparametric magnetic resonance imaging: 59 (26.1%) patients without visible tumor (group B) and 167 (73.9%) patients with visible tumor (group C). We evaluated the pathologic outcomes of organ-confined Gleason ≤6 disease and unfavorable disease in each group. Results: The proportions of organ-confined Gleason ≤6 disease and unfavorable disease were 63.9 and 11.3% in group A, 59.3 and 10.2% in group B, and 38.9 and 22.8% in Group C. Comparing group A and B, these proportions were not statistically different (P = 0.549 and P = 1.000, respectively). However, comparing group A and C, those were significantly different (P< 0.001 and P = 0.002, respectively). In multivariate logistic regression analysis, no visible tumor on multiparametric magnetic resonance imaging was an independent predictor of organ-confined Gleason score 6 disease (odds ratio 0.426, P = 0.007) but there was no statistically independent predictor for unfavorable disease. Conclusions: The tumor visibility on multiparametric magnetic resonance imaging could be a predictor of favorable disease for the prostate cancer patients who did not meet active surveillance criteria. Multiparametric magnetic resonance imaging could help to determine treatment modality for the low-risk prostate cancer patients who consider active surveillance even if they did not meet active surveillance criteria.

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DO - 10.1093/jjco/hyt041

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