MP03-07 COMBINED CLINICAL PARAMETERS AND MULTIPARAMETRIC MRI FOR PREDICTION OF SIDE-SPECIFIC EXTRAPROSTATIC DISEASE - A RISK-MODEL FOR PATIENT-TAILORED RISK STRATIFICATION BEFORE RADICAL PROSTATECTOMY

You have accessJournal of UrologyProstate Cancer: Detection & Screening I1 Apr 2017MP03-07 COMBINED CLINICAL PARAMETERS AND MULTIPARAMETRIC MRI FOR PREDICTION OF SIDE-SPECIFIC EXTRAPROSTATIC DISEASE - A RISK-MODEL FOR PATIENT-TAILORED RISK STRATIFICATION BEFORE RADICAL PROSTATECTOMY Jan Philipp Radtke, Boris Hadaschik, Claudia Kesch, Bonekamp David, Martin Freitag, Celine Alt, Bertram Hitthaler, Matthias Claudius Roethke, Kathrin Wieczorek, Wilfried Roth, Stefan Duensing, Heinz-Peter Schlemmer, Markus Hohenfellner, and Dogu Teber Jan Philipp RadtkeJan Philipp Radtke More articles by this author , Boris HadaschikBoris Hadaschik More articles by this author , Claudia KeschClaudia Kesch More articles by this author , Bonekamp DavidBonekamp David More articles by this author , Martin FreitagMartin Freitag More articles by this author , Celine AltCeline Alt More articles by this author , Bertram HitthalerBertram Hitthaler More articles by this author , Matthias Claudius RoethkeMatthias Claudius Roethke More articles by this author , Kathrin WieczorekKathrin Wieczorek More articles by this author , Wilfried RothWilfried Roth More articles by this author , Stefan DuensingStefan Duensing More articles by this author , Heinz-Peter SchlemmerHeinz-Peter Schlemmer More articles by this author , Markus HohenfellnerMarkus Hohenfellner More articles by this author , and Dogu TeberDogu Teber More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.124AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Multiparametric MRI (mpMRI) improves the detection of significant prostate cancer (PC) and extraprostatic extension (EPE). We combined pre-biopsy mpMRI data and clinical parameters to develop a risk model (RM) to predict individual side-specific risk of EPE on radical prostatectomy (RP). METHODS MRI and clinical parameters of 132 men who underwent mpMRI fusion-biopsy and RP were analysed as training set. The RM was validated prospectively in 132 consecutive patients. Multivariate regression analysis was used to determine EPE predictors for RM development. The calibration of the RM was analysed using a calibration plot. The accuracy was compared to digital rectal examination (DRE), ESUR MRI criteria for EPE alone and the nomogram for side-specific EPE prediction of Steuber et al., using receiver operating characteristics (ROC) in training and validation set. Differences between the ROC curves were analysed using Likelihood ratio tests. RESULTS Primary Gleason pattern on biopsy on specific side, ESUR MRI criteria of side-specific lesion, PSA-density, clinical T-stage, lesion volume in milliliter and capsule contact length in millimeter on MRI were significant EPE-predictors and were included in the RM (Figure a). The calibration plot of the RM showed that predicted and actual probabilities were close (slope 1.12)(Figure b). ROC area under the curve (AUC) for the RM was significantly larger in both sets (0.88 and 0.84), compared to DRE (0.69, p=0.004, 0.66, p<0.001) and the risk model of Steuber et al. (0.77, p=0.009, 0.71, p=0.006). Compared to ESUR criteria (AUC 0.87 and 0.80), the AUC was only significant larger in the validation set (p=0.03) (Figure c/d). CONCLUSIONS The RM, incorporating clinical and standardized MRI parameters performed significantly better compared to a renowned risk model, ESUR MRI criteria and clinical parameters alone. Thus, it provides accurate individual risk stratification of side-specific EPE of prostate cancers prior to RP. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e21-e22 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Jan Philipp Radtke More articles by this author Boris Hadaschik More articles by this author Claudia Kesch More articles by this author Bonekamp David More articles by this author Martin Freitag More articles by this author Celine Alt More articles by this author Bertram Hitthaler More articles by this author Matthias Claudius Roethke More articles by this author Kathrin Wieczorek More articles by this author Wilfried Roth More articles by this author Stefan Duensing More articles by this author Heinz-Peter Schlemmer More articles by this author Markus Hohenfellner More articles by this author Dogu Teber More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...