OncologyImpact of Magnetic Resonance Imaging on Prostate Cancer Staging and European Association of Urology Risk Classification
Section snippets
Patients
This study was approved by the institutional ethical review board of the University Hospitals Leuven (S61308). In this single-institution study, patient charts were reviewed for patients with histologically proven PCa who were treated with a robot-assisted radical prostatectomy (RARP) between April 2016 and December 2017. Patients were excluded for data analysis if they had no registered DRE or if no bpMRI had been performed or evaluated in our center (Fig. 1). A total of 180 patients met these
Patient Characteristics
The characteristics of the 180 enrolled patients are depicted in Table 1. Median age for all patients was 65 years (range 44-76 years). According to the DRE-based clinical staging, 26% of patients were classified as cT2c or higher vs 54% when using MRI-based clinical staging (P <.01). Data on risk group stratification according to the EAU guidelines (low, intermediate, high, and high risk locally advanced) using either DRE or MRI are shown in Table 1. Based on DRE, 39% would be classified as
DISCUSSION
Precise risk group stratification constitutes a prerequisite for establishing the optimal treatment strategy in patients with PCa. Risk stratification for PCa is primarily based on clinical staging by DRE, pretreatment PSA, and biopsy information. The purpose of this study was to evaluate the impact of MRI information on risk stratification and treatment recommendations according to the EAU guidelines.
When compared to the gold standard histopathology, a clear risk of overstaging exists when
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2023, Urologic Oncology: Seminars and Original InvestigationsCitation Excerpt :The current EAU risk groups for prostate cancer do not incorporate radiological staging and are based on Partin tables and D'Amico criteria which were originally developed and validated using clinical stage on DRE [3]. Recently there have been publications that report on the use of mpMRI stage instead of DRE but to our knowledge none have assessed its role in addition to DRE [12,13]. A recent publication by Mazonne et al. proposed a novel classification to predict biochemical recurrence based on clinical and mpMRI parameters [14].
Declarations of Interest: None.
- 1
Steven Joniau is a senior clinical investigator at the Research Foundation Flanders (FWO).
- 2
Karin Haustermans is a senior clinical investigator at the Research Foundation Flanders (FWO).