Oncologic Outcomes after Localized Prostate Cancer Treatment: Associations with Pretreatment Prostate Magnetic Resonance Imaging Findings

No AccessJournal of UrologyAdult Urology1 Apr 2021Oncologic Outcomes after Localized Prostate Cancer Treatment: Associations with Pretreatment Prostate Magnetic Resonance Imaging Findings Andreas G. Wibmer, Joshua Chaim, Yulia Lakhman, Robert A. Lefkowitz, Josip Nincevic, Ines Nikolovski, Evis Sala, Mithat Gonen, Sigrid V. Carlsson, Samson W. Fine, Michael J. Zelefsky, Peter Scardino, Hedvig Hricak, and Hebert Alberto Vargas Andreas G. WibmerAndreas G. Wibmer *Correspondence: Memorial Sloan Kettering Cancer Center, Department of Radiology, 1275 York Avenue, New York, New York 10065 telephone: 646-888-5409; E-mail Address: [email protected] Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York , Joshua ChaimJoshua Chaim Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York , Yulia LakhmanYulia Lakhman Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York , Robert A. LefkowitzRobert A. Lefkowitz Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York , Josip NincevicJosip Nincevic Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York , Ines NikolovskiInes Nikolovski Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York , Evis SalaEvis Sala Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York , Mithat GonenMithat Gonen Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York , Sigrid V. CarlssonSigrid V. Carlsson Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, New York Department of Urology, Sahlgrenska Academy at University of Gothenburg, Institute of Clinical Sciences, Gothenburg, Sweden , Samson W. FineSamson W. Fine Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York , Michael J. ZelefskyMichael J. Zelefsky Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York , Peter ScardinoPeter Scardino Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, New York , Hedvig HricakHedvig Hricak Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York , and Hebert Alberto VargasHebert Alberto Vargas Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York View All Author Informationhttps://doi.org/10.1097/JU.0000000000001474AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We investigated whether T2-weighted magnetic resonance imaging findings could improve upon established prognostic indicators of metastatic disease and prostate cancer specific survival. Materials and Methods: For a cohort of 3,406 consecutive men who underwent prostate magnetic resonance imaging before prostatectomy (2,160) or radiotherapy (1,246) between 2001 and 2006, T2-weighted magnetic resonance imaging exams were retrospectively interpreted and categorized as I) no focal suspicious lesion, II) organ confined focal lesion, III) focal lesion with extraprostatic extension or IV) focal lesion with seminal vesicle invasion. Clinical risk was recorded based on European Association of Urology (EAU) guidelines and the Cancer of the Prostate Risk Assessment (CAPRA) scoring system. Survival probabilities and c-indices were estimated using Cox models and inverse probability censoring weights, respectively. Results: The median followup was 10.8 years (IQR 8.6–13.0). Higher magnetic resonance imaging categories were associated with a higher likelihood of developing metastases (HR 3.5–18.1, p <0.001 for all magnetic resonance imaging categories) and prostate cancer death (HR 3.1–29.7, p <0.001–0.025); these associations were statistically independent of EAU risk categories, CAPRA scores and treatment type (surgery vs radiation). Combining EAU risk or CAPRA scores with magnetic resonance imaging categories significantly improved prognostication of metastases (c-indices: EAU: 0.798, EAU + magnetic resonance imaging: 0.872; CAPRA: 0.808, CAPRA + magnetic resonance imaging: 0.877) and prostate cancer death (c-indices: EAU 0.813, EAU + magnetic resonance imaging: 0.889; CAPRA: 0.814, CAPRA + magnetic resonance imaging: 0.892; p <0.001 for all). Conclusion: Magnetic resonance imaging findings of localized prostate cancer are associated with clinically relevant long-term oncologic outcomes. 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Link, Google Scholar Supported in part through NIH (National Institutes of Health)/NCI (National Cancer Institute) Cancer Center Support Grant P30 CA008748 and NIH/NCI Research Project (R01) CA076423-01A2, as well as the Peter Michael Foundation. © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 205Issue 4April 2021Page: 1055-1062Supplementary Materials Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.Keywordsprognosisprostatic neoplasmsmagnetic resonance imagingrisk assessmentdisease-free survivalAcknowledgmentsAda Muellner, MS edited the manuscript.MetricsAuthor Information Andreas G. Wibmer Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York *Correspondence: Memorial Sloan Kettering Cancer Center, Department of Radiology, 1275 York Avenue, New York, New York 10065 telephone: 646-888-5409; E-mail Address: [email protected] More articles by this author Joshua Chaim Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Yulia Lakhman Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Robert A. Lefkowitz Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Josip Nincevic Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York University Hospital Center Sisters of Mercy, Zagreb, Croatia. More articles by this author Ines Nikolovski Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Evis Sala Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York Department of Radiology, University of Cambridge and Cancer Research UK Cambridge Centre, Cambridge, United Kingdom. More articles by this author Mithat Gonen Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Sigrid V. Carlsson Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, New York Department of Urology, Sahlgrenska Academy at University of Gothenburg, Institute of Clinical Sciences, Gothenburg, Sweden More articles by this author Samson W. Fine Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Michael J. Zelefsky Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Peter Scardino Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Hedvig Hricak Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York Financial and/or other relationship with Ion Beam Applications, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, University of Vienna, DKFZ (German Cancer Research Center) and Euro-BioImaging. Equal study contribution. More articles by this author Hebert Alberto Vargas Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York Equal study contribution. More articles by this author Expand All Supported in part through NIH (National Institutes of Health)/NCI (National Cancer Institute) Cancer Center Support Grant P30 CA008748 and NIH/NCI Research Project (R01) CA076423-01A2, as well as the Peter Michael Foundation. Advertisement PDF DownloadLoading ...