To identify the predictive factors of prostate cancer extracapsular extension (ECE) in an institutional cohort of patients who underwent multiparametric MRI of the prostate prior to radical prostatectomy (RP).
Overall, 126 patients met the selection criteria, and their medical records were retrospectively collected and analysed; 2 experienced radiologists reviewed the imaging studies. Logistic regression analysis was conducted to identify the variables associated to ECE at whole-mount histology of RP specimens; according to the statistically significant variables associated, a predictive model was developed and calibrated with the Hosmer-Lomeshow test.
The predictive ability to detect ECE with the generated model was 81.4% by including the length of capsular involvement (LCI) and intraprostatic perineural invasion (IPNI). The predictive accuracy of the model at the ROC curve analysis showed an area under the curve (AUC) of 0.83 [95% CI (0.76-0.90)], p < 0.001. Concordance between radiologists was substantial in all parameters examined (p < 0.001). Limitations include the retrospective design, limited number of cases, and MRI images reassessment according to PI-RADS v2.0.
The LCI is the most robust MRI factor associated to ECE; in our series, we found a strong predictive accuracy when combined in a model with the IPNI presence. This outcome may prompt a change in the definition of PI-RADS score 5.
World journal of urology. 2024 Jan 13*** epublish ***
Francesco Sanguedolce, Alessandro Tedde, Luisa Granados, Jonathan Hernández, Jorge Robalino, Edgar Suquilanda, Matteo Tedde, Joan Palou, Alberto Breda
Department of Medicine, Surgery and Pharmacy, Universitá degli Studi di Sassari, Sassari, Italy. ., Department of Medicine, Surgery and Pharmacy, Universitá degli Studi di Sassari, Sassari, Italy., Department of Radiology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain., Department of Urology, Fundació Puigvert, Barcelona, Spain., Department of Urology, Università degli Studi di Sassari, Sassari, Italy., Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain.