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 PSA recurrence following prostatectomy.
Clement and colleagues compared the accuracy of side-specific ECE prediction between nomograms with and without multiparametric MRI incorporation.
Harnessing data from 566 prostate half lobes of patients who were subjected to robotic assisted and open radical prostatectomy, the investigators assessed predictive accuracy of the nomograms of Ohori et al. and Steuber et al., externally validating the nomograms. These predictive models assess probability of ECE by integrating variables such as clinical T stage, Gleason score, percent positive cores, percent cancer in the cores from each side, and PSA. Both nomograms have been internally validated to predict the side-specific probability of ECE based on logistic regression analysis. All patients also received multiparametric 1.5 Tesla MRI at least 6 weeks after prostate biopsy.
Advanced disease was observed in 28% of patients in this cohort affording a robust dataset. The observed specificity and sensitivities of the nomograms (Steuber -50% and 71%, Ohori – 71% and 80%) were superior to MRI alone (91% and 30%).
The authors conclude that multiparametric MRI is currently not specific enough to be useful for routine clinical practice, and the prediction of side-specific ECE is more reliable and accurate when done employing existing predictive models.
Abstract Title: Head to head comparison between nomograms and multiparametric MRI to predict side specific extra capsular extension to indicate nerve sparing during radical prostatectomy
Presented by Christophe Clement, Cyrille Bastide, Serge Brunelle, Marc Andre, Jeanne Thomassin, Dominique Rossi, and Jochen Walz 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
