Biparametric Prostate Imaging Reporting and Data System version2 and International Society of Urological Pathology Grade Predict Biochemical Recurrence after Radical Prostatectomy

Nobuyoshi Takeuchi; Shinichi Sakamoto; Akira Nishiyama; Takuro Horikoshi; Yasutaka Yamada; Junpei Iizuka; Maihulan Maimaiti; Yusuke Imamura; Koji Kawamura; Takashi Imamoto; Akira Komiya; Yuzuru Ikehara; Koichiro Akakura; Tomohiko Ichikawa

doi:10.1016/j.clgc.2018.02.011

Biparametric Prostate Imaging Reporting and Data System version2 and International Society of Urological Pathology Grade Predict Biochemical Recurrence after Radical Prostatectomy

Clin Genitourin Cancer. 2018 Aug;16(4):e817-e829. doi: 10.1016/j.clgc.2018.02.011. Epub 2018 Feb 24.

Affiliations

¹ Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan.
² Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan. Electronic address: rbatbat1@gmail.com.
³ Department of Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan.
⁴ Department of Urology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
⁵ Department of Molecular Tumor Pathology, Graduate School of Medicine, Chiba University, Chiba, Japan.
⁶ Department of Urology, Japan Community Health Care Organization, Shinjuku, Tokyo, Japan.

PMID: 29576444
DOI: 10.1016/j.clgc.2018.02.011

Abstract

Background: We retrospectively assessed the clinical significance of the Prostate Imaging Reporting and Data System (PI-RADS), version 2, criteria based on biparametric magnetic resonance imaging (bp-MRI), together with the International Society of Urological Pathology (ISUP) grade, for predicting biochemical recurrence (BCR) after radical prostatectomy.

Materials and methods: The data from 126 patients who had undergone radical prostatectomy were retrospectively analyzed. The prognostic significance of the PI-RADS v2 score based on bp-MRI was assessed with other clinical factors, including the ISUP grade. We defined a positive PI-RADS and ISUP score as ≥ 4 and ≥ 3, respectively. Statistical analysis was performed using Cox proportional hazard models, logistic regression analysis, and the Kaplan-Meier method.

Results: The median age and median prostate-specific antigen level were 66 years and 7.96 ng/mL, respectively. The number of positive PI-RADS scores was 106 (84.1%) and the number of positive ISUP grade scores was 71 (56.3%). PI-RADS ≥ 4 (P = .0031) and ISUP ≥ 3 (P = .070) were the 2 independent prognostic factors predictive of BCR. A positive PI-RADS score was related to tumor volume (P = .014), and a positive ISUP score was related to prostate-specific antigen level (P = .043), extraprostatic extension (P = .029), and Gleason upgrading (P < .0001). After stratifying patients into risk groups according to PI-RADS and ISUP positivity, the poor-risk group (PI-RADS and ISUP grade positive) showed significantly worse BCR-free survival compared with that of the favorable- and intermediate-risk groups (P < .0001), with a median survival difference of 21 months.

Conclusion: Biparametric PI-RADS v2 and ISUP grade criteria predicted for BCR after radical prostatectomy. PI-RADS v2 combined with the ISUP grade might be helpful in choosing the treatment modality of patients with localized prostate cancer.

Keywords: Biparametric MRI; ISUP grade; PI-RADS; Prostate cancer; Tumor volume.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Data Systems
Humans
Kaplan-Meier Estimate
Logistic Models
Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Grading
Neoplasm Recurrence, Local / diagnosis*
Neoplasm Recurrence, Local / metabolism
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Prostate-Specific Antigen / metabolism*
Prostatectomy / methods*
Prostatic Neoplasms / metabolism
Prostatic Neoplasms / surgery*
Retrospective Studies

Substances

Prostate-Specific Antigen