Prognostic value of preoperative multiparametric magnetic resonance imaging (MRI) for predicting biochemical recurrence after radical prostatectomy.
OBJECTIVE
To evaluate the suitability of preoperative multiparametric magnetic resonance imaging (MRI) positivity as a predictor of biochemical recurrence after radical prostatectomy (RP).


METHODS
We reviewed the clinical records of patients who underwent either standard RP or laparoscopic RP between January 2005 and December 2009 at our institution. Patients who received radiotherapy or androgen deprivation therapy before surgery were excluded. A total of 314 patients met the study inclusion criteria. Cox proportional hazard regression models were used for analyses. In accordance with the criteria in the established guidelines, a radiologist scored the probability of the presence of prostate cancer using a five-point scale of diagnostic confidence level. The highest confidence level of any pulse sequence was considered as the evaluation result.


RESULTS
MRI positivity was significantly associated with a high clinical stage (cT ≥ 2; P = 0.039), a high positive biopsy core rate (≥0.2; P < 0.001), a high biopsy Gleason score ([GS] ≥8; P < 0.001) and a high pathological GS (≥8; P = 0.005). Univariate analysis and multivariate analysis showed that MRI positivity was a prognostic indicator in the analysis that included only preoperative variables and also in the analysis including preoperative and pathological variables.


CONCLUSIONS
Multiparametric MRI positivity can independently predict biochemical recurrence after RP.
Department of Urology, Keio University School of Medicine, Tokyo, Japan.
Seiya
S
Hattori
Takeo
T
Kosaka
Ryuichi
R
Mizuno
Kent
K
Kanao
Akira
A
Miyajima
Yota
Y
Yasumizu
Satoshi
S
Yazawa
Hirohiko
H
Nagata
Eiji
E
Kikuchi
Shuji
S
Mikami
Masahiro
M
Jinzaki
Ken
K
Nakagawa
Akihiro
A
Tanimoto
Mototsugu
M
Oya
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D001707:Biopsy, Needle; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000378:metabolism; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D057234:Preoperative Period; D017430:Prostate-Specific Antigen / Q000378:metabolism*; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013997:Time Factors
D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen
MRI; PSA; biochemical recurrence; clinical stage; prostate cancer; radical prostatectomy