SAN DIEGO, CA USA (UroToday.com) - Multiple abstracts in the Prostate Cancer Screening I session focus on MRI as a tool to predict extracapsular extension (ECE) and even PSA recurrence following prostatectomy. Suspicion of ECE, preoperatively, can lead the surgeon to more or less aggressively spare the neurovascular bundle on the side in question. Clement and colleagues compared the accuracy of predictions of side-specific ECE, between nomograms, with and without multiparametric MRI incorporation.
Running 566 prostate half lobes of patients who underwent robotic assisted and open radical prostatectomy through the full models of the nomograms of Ohori et al. and Steuber et al., the authors externally validated nomograms for predictive accuracy. All patients received multi-parametric 1.5 Tesla MRI at least 6 weeks after prostate biopsy.
pT3 disease was observed in 28% of patients (pT3a -21%, pT3b - 7%). Specificity and sensitivities of the nomograms (Steuber -50% and 71%, Ohori - 71% and 80%) were superior to MRI (91% and 30%).
The authors conclude that multi-parametric MRI is currently not specific enough to be useful in daily practice, and the prediction of side-specific ECE is more reliable and accurate when done by simple nomograms.
Presented by Ahmed Elshafei, Yonghong Li, Asmaa Hatem, Ayman Moussa, Shoshana Weiner, Andrew Stephenson, Anthony Avallone, and J. Stephen Jones at the American Urological Association (AUA) Annual Meeting - May 4 - 8, 2013 - San Diego Convention Center - San Diego, California USA
Reported for UroToday.com by Anthony T. Corcoran, MD
