Pawel Rajwa1,2, Keiichiro Mori1,3, Nicolai A Huebner1,4, Darryl T Martin5, Preston C Sprenkle5, Jeffrey C Weinreb6, Guillaume Ploussard7, Benjamin Pradere1, Shahrokh F Shariat1,8,9,10,11,12, Michael S Leapman5. 1. Department of Urology, Medical University of Vienna, Vienna, Austria. 2. Department of Urology, Medical University of Silesia, Zabrze, Poland. 3. Department of Urology, The Jikei University School of Medicine, Tokyo, Japan. 4. Working Group for Diagnostic Imaging in Urology (ABDU), Austrian Association of Urology (ÖGU), Vienna, Austria. 5. Department of Urology, Yale School of Medicine, New Haven, Connecticut. 6. Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut. 7. Department of Urology, La Croix du Sud Hospital, Quint Fonsegrives, France. 8. Department of Urology, Weill Cornell Medical College, New York, New York. 9. Department of Urology, University of Texas Southwestern, Dallas, Texas. 10. Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria. 11. Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic. 12. Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
Abstract
PURPOSE: Although the Prostate Imaging-Reporting and Data System version 2 (PI-RADS v2) is a reliable diagnostic tool for significant prostate cancer (PCa), less is known about the prognostic significance of the structured reporting scheme for estimating oncologic outcomes after treatment. We aimed to synthesize the available evidence regarding the association of PI-RADS v2 score and risk of biochemical recurrence (BCR) among patients undergoing primary definitive treatment for prostate cancer. MATERIALS AND METHODS: We systematically queried the PubMed and Web of Science databases to identify studies addressing the association between the PI-RADS v2 and treatment outcomes. We included studies through November 2020 that assessed the independent prognostic significance of PI-RADS v2. After assessing risk of bias and quality, we conducted a formal meta-analysis to estimate the pooled effects of prostate MRI classification on the risk of BCR. RESULTS: We identified nine and seven eligible studies including 2,274 and 1,215 patients for the systematic review and meta-analysis, respectively. Eight were conducted in the context of radical prostatectomy and one post-radiation. Among patients treated with radical prostatectomy, higher PI-RADS v2 scores were significantly associated with risk of BCR (pooled HR 3.06, 95% CI 2.16-4.33; p <0.01). There was no significant heterogeneity among studies. For all studies, PI-RADS v2 value remained significantly associated with BCR (pooled 3.19, 95% CI 2.28-4.45; p <0.01). CONCLUSIONS: Prostate MRI findings assessed with the PI-RADS v2 classification were independently associated with risk of BCR after definitive local therapy, primarily based on data from radical prostatectomy. These findings support the use of prostate MRI as a prognostic marker, in addition to its role in PCa diagnosis.
PURPOSE: Although the Prostate Imaging-Reporting and Data System version 2 (PI-RADS v2) is a reliable diagnostic tool for significant prostate cancer (PCa), less is known about the prognostic significance of the structured reporting scheme for estimating oncologic outcomes after treatment. We aimed to synthesize the available evidence regarding the association of PI-RADS v2 score and risk of biochemical recurrence (BCR) among patients undergoing primary definitive treatment for prostate cancer. MATERIALS AND METHODS: We systematically queried the PubMed and Web of Science databases to identify studies addressing the association between the PI-RADS v2 and treatment outcomes. We included studies through November 2020 that assessed the independent prognostic significance of PI-RADS v2. After assessing risk of bias and quality, we conducted a formal meta-analysis to estimate the pooled effects of prostate MRI classification on the risk of BCR. RESULTS: We identified nine and seven eligible studies including 2,274 and 1,215 patients for the systematic review and meta-analysis, respectively. Eight were conducted in the context of radical prostatectomy and one post-radiation. Among patients treated with radical prostatectomy, higher PI-RADS v2 scores were significantly associated with risk of BCR (pooled HR 3.06, 95% CI 2.16-4.33; p <0.01). There was no significant heterogeneity among studies. For all studies, PI-RADS v2 value remained significantly associated with BCR (pooled 3.19, 95% CI 2.28-4.45; p <0.01). CONCLUSIONS: Prostate MRI findings assessed with the PI-RADS v2 classification were independently associated with risk of BCR after definitive local therapy, primarily based on data from radical prostatectomy. These findings support the use of prostate MRI as a prognostic marker, in addition to its role in PCa diagnosis.
Authors: Marcin Miszczyk; Justyna Rembak-Szynkiewicz; Łukasz Magrowski; Konrad Stawiski; Agnieszka Namysł-Kaletka; Aleksandra Napieralska; Małgorzata Kraszkiewicz; Grzegorz Woźniak; Małgorzata Stąpór-Fudzińska; Grzegorz Głowacki; Benjamin Pradere; Ekaterina Laukhtina; Paweł Rajwa; Wojciech Majewski Journal: Cancers (Basel) Date: 2022-03-23 Impact factor: 6.639