Mp52-03 Preoperative Risk Model of Biochemical Recurrence After Robotic-Assisted Radical Prostatectomy With Pi-Rads Category 5 of Multiparametric Mri

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy II (MP52)1 May 2024MP52-03 PREOPERATIVE RISK MODEL OF BIOCHEMICAL RECURRENCE AFTER ROBOTIC-ASSISTED RADICAL PROSTATECTOMY WITH PI-RADS CATEGORY 5 OF MULTIPARAMETRIC MRI Yutaka Horiguchi, Kiichi Hagiwara, Toshihiro Shimizu, Yoshiyuki Kawano, Noboru Sakamoto, Fumio Tsukuda, and Shoji Koga Yutaka HoriguchiYutaka Horiguchi , Kiichi HagiwaraKiichi Hagiwara , Toshihiro ShimizuToshihiro Shimizu , Yoshiyuki KawanoYoshiyuki Kawano , Noboru SakamotoNoboru Sakamoto , Fumio TsukudaFumio Tsukuda , and Shoji KogaShoji Koga View All Author Informationhttps://doi.org/10.1097/01.JU.0001008864.84854.b7.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The Prostate Imaging Reporting and Data System (PI-RADS) for MRI, proposed for the diagnosis of prostate cancer, was revised to version 2.1 in 2019, and its usefulness has been demonstrated in MRI-US fusion-guided biopsy. Recently, PI-RADS is reported to be associated with the extra prostatic extension (EPE) in the pathological diagnosis of robotic-assisted radical prostatectomy (RARP) and useful for predicting biochemical recurrence (BCR). Here, we constructed a prognostic risk model using PI-RADS category 5 of multiparametric MRI (mpMRI) for BCR after RARP in Japanese cohort. METHODS: Of a total of 1321 consecutive prostate biopsies performed in our hospital between July 2015 and December 2021, mpMRI was performed before the biopsy in 1300 cases. All MRI images were reassessed according to the definition of PI-RADS v 2.1 by consensus of 3 individual urologists. 827 cases were diagnosed with prostate cancer. We statistically evaluated the correlation between the PI-RADS category and BCR in 269 patients who underwent RARP and were observed for 12≤ months postoperatively. BCR was defined as a postoperative PSA of 0.2≤ ng/mL. RESULTS: The median age and PSA of the 269 patients were 70.0 years and 8.26 ng/mL. The median follow-up period was 46.6 months. 63 patients have developed BCR with 5-year BCR-free rates of 73.9%. BCR ranged in 38 of 89 patients (42.7%) in PI-RADS 5, 23 of 121 (19.0%) in PI-RADS 4, and 2 of 59 (3.4%) in PI-RADS 3 or less. PI-RADS 5 was significantly correlated with the RARP pathology. Among preoperative factors, PSAD ≥0.210 ng/mL/cc, PI-RADS 5, positive rate of biopsy core (%PC) ≥50% and biopsy grade group (bGG) ≥4 were independent predictors of BCR in Cox proportional hazards model multivariate analysis. As a result of constructing a preoperative BCR risk prediction model with these 4 factors, 38 of 60 patients (63.3%) in the high risk group (3≤ points) had BCR, while only 1 of 63 patients (1.6%) in the low risk group (0 points) had BCR (p<0.0001, Log-rank). CONCLUSIONS: A PI-RADS category 5 of mpMRI was significantly correlated with RARP pathological features and independent predictor of postoperative risk for the future BCR along with PSAD, %PC and bGG. Preoperative risk model based on these 4 factors was useful in considering the treatment strategies prior to RARP. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e852 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Yutaka Horiguchi More articles by this author Kiichi Hagiwara More articles by this author Toshihiro Shimizu More articles by this author Yoshiyuki Kawano More articles by this author Noboru Sakamoto More articles by this author Fumio Tsukuda More articles by this author Shoji Koga More articles by this author Expand All Advertisement PDF downloadLoading ...