Pd47-07 targeted cancer core length and risk-stratification of prostate cancer

You have accessJournal of UrologyProstate Cancer: Staging II1 Apr 2018PD47-07 TARGETED CANCER CORE LENGTH AND RISK-STRATIFICATION OF PROSTATE CANCER Demetrios Simopoulos, Anthony Sisk, Alan Priester, Lorna Kwan, Robert Reiter, and Leonard Marks Demetrios SimopoulosDemetrios Simopoulos More articles by this author , Anthony SiskAnthony Sisk More articles by this author , Alan PriesterAlan Priester More articles by this author , Lorna KwanLorna Kwan More articles by this author , Robert ReiterRobert Reiter More articles by this author , and Leonard MarksLeonard Marks More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2167AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Tumor volume (TV) may be an important predictor of biological potential of prostate cancer (CaP), but pre-operative determination of TV is problematic. MRI-visible lesions (region of interest, ROI) underestimate TV (J.Urol. 197:320, 2017). As a possible predictor of TV, we studied the relationship of maximal cancer core length (MCCL), obtained by targeted biopsy of an MRI-visible lesion, to actual volume of that tumor found in men undergoing radical prostatectomy (RRP). METHODS Subjects were all 175 men who underwent RRP with prostate tumor volumetrics (2010-2016). Whole-mount prostates were evaluated via custom-mold processing. In 114 men MCCL came from an index MRI-visible lesion (PI-RADS ≥3). In 61 men MCCL was obtained from a non-targeted lesion (i.e., systematic biopsy) which was not visible on MRI. The 2 cohorts were matched (age, PSA, prostate volume). MCCL was defined as longest continuous stretch of tumor (mm) in a single biopsy core. MRI was 3T multi-parametric and biopsy was via MRI-US fusion (Cancer 122:884, 2016). RESULTS In the targeted cohort, MCCL correlated with index TV (Fig), and the correlation coefficient increased with increasing Gleason score: r=0.19 for GS=6 (NS), r=0.45 for GS=7 (p<0.01), and r=0.57 for GS ≥8 (p<0.01). In the systematic cohort, no correlation was found between MCCL and index TV. In multivariate analysis, patients in the targeted cohort with MCCL > 10 mm had a greater TV than patients with MCCL <6 mm (β=4.45 cc; CI 1.63, 7.28; p<0.01). MCCL >10 mm was associated with pathological T3 disease (OR 5.5), as was Gleason score >6 (OR 2.1) (Table). CONCLUSIONS MCCL on a targeted biopsy from an MRI-visible lesion (PI-RADS 3-5) is an independent predictor of both cancer volume and pathologic stage. Non-targeted biopsies lack this utility. Quantifying MCCL on MRI-targeted biopsies may have a value, not previously described, in helping to risk-stratify patients with CaP. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e899-e900 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Demetrios Simopoulos More articles by this author Anthony Sisk More articles by this author Alan Priester More articles by this author Lorna Kwan More articles by this author Robert Reiter More articles by this author Leonard Marks More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...