Sami-Ramzi Leyh-Bannurah1,2, Mykyta Kachanov3, Pierre I Karakiewicz4, Dirk Beyersdorff3,5, Raisa S Pompe6, Su Jung Oh-Hohenhorst3,7, Margit Fisch6, Tobias Maurer3,6, Markus Graefen3, Lars Budäus3. 1. Martini-Klinik, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany. S.Bannurah@googlemail.com. 2. Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. S.Bannurah@googlemail.com. 3. Martini-Klinik, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany. 4. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada. 5. Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 6. Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 7. Institute of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Abstract
OBJECTIVE: Based on unfavorable oncological and functional outcomes of non-organ-confined (NOC) prostate cancer (PCa), defined as ≥ pT3, pN1 or both, we aimed to develop a NOC prediction tool based on multiparametric MRI-guided targeted fusion biopsy (TBx). MATERIALS AND METHODS: Analyses were restricted to 594 patients with simultaneous PCa detection at systematic biopsy (SBx), TBx and subsequent radical prostatectomy (RP) at our institution. Development (n = 396; cohort 1) and validation cohorts (n = 198; cohort 2) were used to develop and validate the NOC nomogram. A head-to-head comparison was performed between stand-alone TBx model and combined TBx/SBx model. Second validation was performed in patients with positive TBx, but negative SBx (n = 193; cohort 3). RESULTS: The most parsimonious TBx model included three independent predictors of NOC: pretreatment PSA (OR 1.05 95% CI: 1.01-1.08), highest TBx-detected Gleason pattern (3 + 3 [REF] vs. ≥ 4 + 5; OR 9.3 95% CI 3.8-22) and presence of TBx-detected perineural invasion (OR 2.2 95% CI: 1.3-3.6). The combined TBx/SBx model had the same predictors. For the stand-alone TBx and combined TBx/SBx model, external validation yielded accuracy of 76.5% (95% CI: 69.3-83.1) and 76.6% (95% CI: 69.4-83.6) within cohort 2. The external validation of the stand-alone TBx model yielded 72.4% (95% CI: 65.0-79.6) accuracy within cohort 3. CONCLUSION: Our stand-alone TBx-based nomogram can identify PCa patients at the risk of NOC, using three simple variables, with the similar accuracy as the TBx/SBx-based model. It is non-inferior to combined TBx/SBx-based model and performs with sufficient accuracy in specific patients with positive TBx, but negative SBx.
OBJECTIVE: Based on unfavorable oncological and functional outcomes of non-organ-confined (NOC) prostate cancer (PCa), defined as ≥ pT3, pN1 or both, we aimed to develop a NOC prediction tool based on multiparametric MRI-guided targeted fusion biopsy (TBx). MATERIALS AND METHODS: Analyses were restricted to 594 patients with simultaneous PCa detection at systematic biopsy (SBx), TBx and subsequent radical prostatectomy (RP) at our institution. Development (n = 396; cohort 1) and validation cohorts (n = 198; cohort 2) were used to develop and validate the NOC nomogram. A head-to-head comparison was performed between stand-alone TBx model and combined TBx/SBx model. Second validation was performed in patients with positive TBx, but negative SBx (n = 193; cohort 3). RESULTS: The most parsimonious TBx model included three independent predictors of NOC: pretreatment PSA (OR 1.05 95% CI: 1.01-1.08), highest TBx-detected Gleason pattern (3 + 3 [REF] vs. ≥ 4 + 5; OR 9.3 95% CI 3.8-22) and presence of TBx-detected perineural invasion (OR 2.2 95% CI: 1.3-3.6). The combined TBx/SBx model had the same predictors. For the stand-alone TBx and combined TBx/SBx model, external validation yielded accuracy of 76.5% (95% CI: 69.3-83.1) and 76.6% (95% CI: 69.4-83.6) within cohort 2. The external validation of the stand-alone TBx model yielded 72.4% (95% CI: 65.0-79.6) accuracy within cohort 3. CONCLUSION: Our stand-alone TBx-based nomogram can identify PCapatients at the risk of NOC, using three simple variables, with the similar accuracy as the TBx/SBx-based model. It is non-inferior to combined TBx/SBx-based model and performs with sufficient accuracy in specific patients with positive TBx, but negative SBx.
Authors: Mike Wenzel; Felix Preisser; Clarissa Wittler; Benedikt Hoeh; Peter J Wild; Alexandra Tschäbunin; Boris Bodelle; Christoph Würnschimmel; Derya Tilki; Markus Graefen; Andreas Becker; Pierre I Karakiewicz; Felix K H Chun; Luis A Kluth; Jens Köllermann; Philipp Mandel Journal: Diagnostics (Basel) Date: 2021-05-15
Authors: Iulia Andras; Emanuel Darius Cata; Andreea Serban; Pierre Kadula; Teodora Telecan; Maximilian Buzoianu; Maria Bungardean; Dan Vasile Stanca; Ioan Coman; Nicolae Crisan Journal: Medicina (Kaunas) Date: 2021-05-22 Impact factor: 2.430