Department of Urology, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany.
Department of Urology, Ruhr-University Bochum, Marien Hospital, Herne, Germany.
World J Urol. 2024 Sep 20;42(1):530. doi: 10.1007/s00345-024-05232-6.
This study aimed to validate a previously published risk model (RM) which combines clinical and multiparametric MRI (mpMRI) parameters to predict extraprostatic extension (EPE) of prostate cancer (PC) prior to radical prostatectomy (RP).
A previously published RM combining clinical with mpMRI parameters including European Society of Urogenital Radiology (ESUR) classification for EPE was retrospectively evaluated in a cohort of two urological university hospitals in Germany. Consecutive patients (n = 205, January 2015 -June 2021) with available preoperative MRI images, clinical information including PSA, prostate volume, ESUR classification for EPE, histopathological results of MRI-fusion biopsy and RP specimen were included. Validation was performed by receiver operating characteristic analysis and calibration plots. The RM's performance was compared to ESUR criteria.
Histopathological T3 stage was detected in 43% of the patients (n = 89); 45% at Essen and 42% at Düsseldorf. Discrimination performance between pT2 and pT3 of the RM in the entire cohort was AUC = 0.86 (AUC = 0.88 at site 1 and AUC = 0.85 at site 2). Calibration was good over the entire probability range. The discrimination performance of ESUR classification alone was comparable (AUC = 0.87).
The RM showed good discriminative performance to predict EPE for decision-making for RP as a patient-tailored risk stratification. However, when experienced MRI reading is available, standardized MRI reading with ESUR scoring is comparable regarding information outcome. A main limitation is the potentially limited transferability to other populations because of the high prevalence of EPE in our subgroups.
本研究旨在验证先前发表的一种风险模型（RM），该模型结合临床和多参数 MRI（mpMRI）参数，以预测接受根治性前列腺切除术（RP）前前列腺癌（PC）的前列腺外延伸（EPE）。
回顾性评估了德国两家泌尿科大学医院队列中先前发表的一种结合临床和 mpMRI 参数的 RM，其中包括欧洲泌尿生殖放射学会（ESUR）EPE 分类。纳入了具有术前 MRI 图像、包括 PSA、前列腺体积、ESUR EPE 分类、MRI 融合活检和 RP 标本的组织病理学结果在内的临床信息的连续患者（n=205，2015 年 1 月至 2021 年 6 月）。通过接受者操作特征分析和校准图进行验证。将 RM 的性能与 ESUR 标准进行比较。
在患者中，43%（n=89）检测到组织病理学 T3 期；埃森 45%，杜塞尔多夫 42%。RM 在整个队列中区分 pT2 和 pT3 的表现为 AUC=0.86（1 号地点 AUC=0.88，2 号地点 AUC=0.85）。整个概率范围内校准情况良好。ESUR 分类的单独区分性能相当（AUC=0.87）。
RM 显示出良好的鉴别性能，可用于预测 RP 的 EPE，作为患者个体化的风险分层。然而，当有经验的 MRI 阅读可用时，具有 ESUR 评分的标准化 MRI 阅读在信息结果方面是可比的。主要限制是由于我们的亚组中 EPE 的高患病率，可能限制了向其他人群的转移。
