OBJECTIVE: The purpose of this study was to determine the frequency and incremental prognostic importance of gross locally advanced disease seen at endorectal MRI in patients with prostate cancer. MATERIALS AND METHODS: We retrospectively identified the cases of all patients with biopsy-proven prostate cancer who underwent pretreatment endorectal MRI over a 6-year period (n = 1777). Three experienced radiologists identified by consensus patients with gross locally advanced disease, defined as unequivocal extracapsular extension or unequivocal seminal vesicle invasion. Outcome among these patients was compared with that in a control group without gross locally advanced disease matched by D'Amico risk stratification. RESULTS: Sixty-six of 1777 (3.7%) patients had gross locally advanced disease. One of 1085 (0.1%) patients had low-risk disease, 25 of 489 (5.1%) had intermediate-risk disease, and 40 of 203 (19.7%) had high-risk disease. Follow-up data were available for 44 of these 66 patients. During a median follow-up period of 79 months, biochemical failure and metastasis had developed in 17 and 6 of these 44 patients compared with 9 and none of the 65 patients in the control group (p < 0.001). CONCLUSION: Almost 4% of patients with prostate cancer, particularly those with intermediate- and high-risk disease, have gross locally advanced disease at endorectal MRI and have a significantly worse prognosis than matched controls. These patients may be candidates for more aggressive treatment.
OBJECTIVE: The purpose of this study was to determine the frequency and incremental prognostic importance of gross locally advanced disease seen at endorectal MRI in patients with prostate cancer. MATERIALS AND METHODS: We retrospectively identified the cases of all patients with biopsy-proven prostate cancer who underwent pretreatment endorectal MRI over a 6-year period (n = 1777). Three experienced radiologists identified by consensus patients with gross locally advanced disease, defined as unequivocal extracapsular extension or unequivocal seminal vesicle invasion. Outcome among these patients was compared with that in a control group without gross locally advanced disease matched by D'Amico risk stratification. RESULTS: Sixty-six of 1777 (3.7%) patients had gross locally advanced disease. One of 1085 (0.1%) patients had low-risk disease, 25 of 489 (5.1%) had intermediate-risk disease, and 40 of 203 (19.7%) had high-risk disease. Follow-up data were available for 44 of these 66 patients. During a median follow-up period of 79 months, biochemical failure and metastasis had developed in 17 and 6 of these 44 patients compared with 9 and none of the 65 patients in the control group (p < 0.001). CONCLUSION: Almost 4% of patients with prostate cancer, particularly those with intermediate- and high-risk disease, have gross locally advanced disease at endorectal MRI and have a significantly worse prognosis than matched controls. These patients may be candidates for more aggressive treatment.
Authors: Amita Shukla-Dave; Hedvig Hricak; Michael W Kattan; Darko Pucar; Kentaro Kuroiwa; Hui-Ni Chen; Jessica Spector; Jason A Koutcher; Kristen L Zakian; Peter T Scardino Journal: BJU Int Date: 2007-01-12 Impact factor: 5.588
Authors: Mack Roach; Gerald Hanks; Howard Thames; Paul Schellhammer; William U Shipley; Gerald H Sokol; Howard Sandler Journal: Int J Radiat Oncol Biol Phys Date: 2006-07-15 Impact factor: 7.038
Authors: A V D'Amico; R Whittington; S B Malkowicz; J Fondurulia; M H Chen; I Kaplan; C J Beard; J E Tomaszewski; A A Renshaw; A Wein; C N Coleman Journal: J Clin Oncol Date: 1999-01 Impact factor: 44.544
Authors: Matthew R Cooperberg; David J Pasta; Eric P Elkin; Mark S Litwin; David M Latini; Janeen Du Chane; Peter R Carroll Journal: J Urol Date: 2005-06 Impact factor: 7.450
Authors: G J Jager; E T Ruijter; C A van de Kaa; J J de la Rosette; G O Oosterhof; J R Thornbury; J O Barentsz Journal: AJR Am J Roentgenol Date: 1996-04 Impact factor: 3.959
Authors: David A McKenna; Fergus V Coakley; Antonio C Westphalen; Shoujun Zhao; Ying Lu; Emily M Webb; Barby Pickett; Mack Roach; John Kurhanewicz Journal: Radiology Date: 2008-02-07 Impact factor: 11.105