title: Predicting Pathological Features at Radical Prostatectomy in Patients with Prostate Cancer Eligible for Active Surveillance by Multiparametric Magnetic Resonance Imaging.
abstract: OBJECTIVE
  The aim of this study was to investigate the prognostic performance of multiparametric magnetic resonance imaging (mpMRI) and Prostate Imaging Reporting and Data System (PIRADS) score in predicting pathologic features in a cohort of patients eligible for active surveillance who underwent radical prostatectomy.
  
  
  METHODS
  A total of 223 patients who fulfilled the criteria for "Prostate Cancer Research International: Active Surveillance", were included. Mp-1.5 Tesla MRI examination staging with endorectal coil was performed at least 6-8 weeks after TRUS-guided biopsy. In all patients, the likelihood of the presence of cancer was assigned using PIRADS score between 1 and 5. Outcomes of interest were: Gleason score upgrading, extra capsular extension (ECE), unfavorable prognosis (occurrence of both upgrading and ECE), large tumor volume (≥ 0.5 ml), and seminal vesicle invasion (SVI). Receiver Operating Characteristic (ROC) curves and Decision Curve Analyses (DCA) were performed for models with and without inclusion of PIRADS score.
  
  
  RESULTS
  Multivariate analysis demonstrated the association of PIRADS score with upgrading (P < 0.0001), ECE (P < 0.0001), unfavorable prognosis (P < 0.0001), and large tumor volume (P = 0.002). ROC curves and DCA showed that models including PIRADS score resulted in greater net benefit for almost all the outcomes of interest, with the only exception of SVI.
  
  
  CONCLUSIONS
  mpMRI and PIRADS scoring are feasible tools in clinical setting and could be used as decision-support systems for a more accurate selection of patients eligible for AS.
authors.affiliation: Division of Urology, European Institute of Oncology, Milan, Italy.
authors.forename: Ottavio
authors.initials: O
authors.lastname: de Cobelli
authors.affiliation: Department of Translational Medical Sciences, University "Federico II", Naples, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Terracciano
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Tagliabue
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Raimondi
authors.affiliation: Division of Urology, European Institute of Oncology, Milan, Italy.
authors.forename: Danilo
authors.initials: D
authors.lastname: Bottero
authors.affiliation: Division of Urology, European Institute of Oncology, Milan, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cioffi
authors.affiliation: Department of Radiotherapy, European Institute of Oncology, Milan, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Jereczek-Fossa
authors.affiliation: Department of Radiology, European Institute of Oncology, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Petralia
authors.affiliation: Division of Urology, European Institute of Oncology, Milan, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cordima
authors.affiliation: University of Vale do Itajaí, Catarinense Institute of Urology, Division of Laparoscopy, Itajaí, Brazil.
authors.forename: Gilberto Laurino
authors.initials: GL
authors.lastname: Almeida
authors.affiliation: Department of Emergency and Organ Transplantation, Urology and Kidney Transplantation Unit, University of Bari, Bari, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lucarelli
authors.affiliation: Division of Medical Oncology, CROB-IRCCS, Rionero in Vulture, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Buonerba
authors.affiliation: Division of Urology, European Institute of Oncology, Milan, Italy.
authors.forename: Deliu Victor
authors.initials: DV
authors.lastname: Matei
authors.affiliation: Division of Pathology, European Institute of Oncology, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Renne
authors.affiliation: Medical Oncology Unit, Department of Clinical Medicine, Federico II University, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Lorenzo
authors.affiliation: Division of Urology, European Institute of Oncology, Milan, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Ferro
mesh_terms: D001706:Biopsy / Q000379:methods; D003661:Decision Support Techniques; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading / Q000379:methods; D009367:Neoplasm Staging / Q000379:methods; D011379:Prognosis; D011467:Prostate / Q000473:pathology*; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000473:pathology*; D012372:ROC Curve; D012189:Retrospective Studies; D012669:Seminal Vesicles / Q000473:pathology