OBJECTIVES: To test the hypothesis that men with prostate cancer (PCA) and preoperative disease features considered favorable for focal treatment would be accurately characterized with transrectal biopsy and prostate magnetic resonance imaging (MRI) by performing a retrospective analysis of a selected cohort of such patients treated with radical prostatectomy (RP). METHODS: A total of 202 patients with PCA who had preoperative MRI and low-risk biopsy criteria (no Gleason grade 4/5, 1 involved core, < 2 mm, PSA density < or = 0.10, clinical stage < or = T2a) were included in the study. Indolent RP pathology was defined as no Gleason 4/5, organ confined, tumor volume < 0.5 mL, and negative surgical margins. MRI ability to locate and determine the tumor extent was assessed. RESULTS: After RP, 101 men (50%) had nonindolent cancer. Multifocal and bilateral tumors were present in 81% and 68% of patients, respectively. MRI indicated extensive disease in 16 (8%). MRI sensitivity to locate PCA ranged from 2% to 20%, and specificity from 91% to 95%. On univariate analysis, MRI evidence of extracapsular extension (P = .027) and extensive disease (P = .001) were associated with nonindolent cancer. On multivariate analysis, only the latter remained as significant predictor (P = .0018). CONCLUSIONS: Transrectal biopsy identified men with indolent tumors favorable for focal treatment in 50% of cases. MRI findings of extracapsular extension and extensive tumor involving more than half of the gland are associated with unfavorable features, and may be useful in excluding patients from focal treatment. According to these data, endorectal MRI is not sufficient to localize small tumors for focal treatment. 2010 Elsevier Inc. All rights reserved.
OBJECTIVES: To test the hypothesis that men with prostate cancer (PCA) and preoperative disease features considered favorable for focal treatment would be accurately characterized with transrectal biopsy and prostate magnetic resonance imaging (MRI) by performing a retrospective analysis of a selected cohort of such patients treated with radical prostatectomy (RP). METHODS: A total of 202 patients with PCA who had preoperative MRI and low-risk biopsy criteria (no Gleason grade 4/5, 1 involved core, < 2 mm, PSA density < or = 0.10, clinical stage < or = T2a) were included in the study. Indolent RP pathology was defined as no Gleason 4/5, organ confined, tumor volume < 0.5 mL, and negative surgical margins. MRI ability to locate and determine the tumor extent was assessed. RESULTS: After RP, 101 men (50%) had nonindolent cancer. Multifocal and bilateral tumors were present in 81% and 68% of patients, respectively. MRI indicated extensive disease in 16 (8%). MRI sensitivity to locate PCA ranged from 2% to 20%, and specificity from 91% to 95%. On univariate analysis, MRI evidence of extracapsular extension (P = .027) and extensive disease (P = .001) were associated with nonindolent cancer. On multivariate analysis, only the latter remained as significant predictor (P = .0018). CONCLUSIONS: Transrectal biopsy identified men with indolent tumors favorable for focal treatment in 50% of cases. MRI findings of extracapsular extension and extensive tumor involving more than half of the gland are associated with unfavorable features, and may be useful in excluding patients from focal treatment. According to these data, endorectal MRI is not sufficient to localize small tumors for focal treatment. 2010 Elsevier Inc. All rights reserved.
Authors: E David Crawford; Shandra S Wilson; Kathleen C Torkko; Daisaku Hirano; J Scott Stewart; Craig Brammell; R Storey Wilson; Nozomu Kawata; Holly Sullivan; M Scott Lucia; Priya N Werahera Journal: BJU Int Date: 2005-11 Impact factor: 5.588
Authors: Claire Hardie; Chris Parker; Andrew Norman; Ros Eeles; Alan Horwich; Robert Huddart; David Dearnaley Journal: BJU Int Date: 2005-05 Impact factor: 5.588
Authors: Matthew R Cooperberg; Deborah P Lubeck; Maxwell V Meng; Shilpa S Mehta; Peter R Carroll Journal: J Clin Oncol Date: 2004-06-01 Impact factor: 44.544
Authors: Hebert Alberto Vargas; Oguz Akin; Amita Shukla-Dave; Jingbo Zhang; Kristen L Zakian; Junting Zheng; Kent Kanao; Debra A Goldman; Chaya S Moskowitz; Victor E Reuter; James A Eastham; Peter T Scardino; Hedvig Hricak Journal: Radiology Date: 2012-09-05 Impact factor: 11.105
Authors: Berrend G Muller; Jurgen J Fütterer; Rajan T Gupta; Aaron Katz; Alexander Kirkham; John Kurhanewicz; Judd W Moul; Peter A Pinto; Ardeshir R Rastinehad; Cary Robertson; Jean de la Rosette; Rafael Sanchez-Salas; J Stephen Jones; Osamu Ukimura; Sadhna Verma; Hessel Wijkstra; Michael Marberger Journal: BJU Int Date: 2013-11-13 Impact factor: 5.588
Authors: Jung J Kang; Robert E Reiter; Nicolas Kummer; Jean DeKernion; Michael L Steinberg; Christopher R King Journal: Am J Clin Oncol Date: 2018-01 Impact factor: 2.339