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Added value of shear-wave elastography in the prediction of Extracapsular extension and seminal vesicle invasion before radical prostatectomy

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Asian Journal of Andrology 2023年第2期25卷 259-264页

作者： Yi-Kang Sun Yang Yu Guang Xu Jian Wu Yun-Yun Liu Shuai Wang Lin Dong Li-Hua Xiang Hui-Xiong Xu Department of Medical Ultrasound Center of Minimally Invasive Treatment for TumorShanghai Tenth People’s HospitalUltrasound Research and Education InstituteClinical Research Center for Interventional MedicineSchool of MedicineTongji UniversityShanghai 200072China Department of Ultrasound Zhongshan HospitalInstitute of Ultrasound in Medicine and EngineeringFudan UniversityShanghai 200032China Department of Urology Shanghai Tenth People’s HospitalSchool of MedicineTongji UniversityShanghai 200072China

The purpose of this study was to analyze the value of transrectal shear-wave elastography(SWE)in combination with multivariable tools for predicting adverse pathological features before radical prostatectomy(RP).Preoperative clinicopathological variables,multiparametric magnetic resonance imaging(mp-MRI)manifestations,and the maximum elastic value of the prostate(Emax)on SWE were retrospectively collected.The accuracy of SWE for predicting adverse pathological features was evaluated based on postoperative pathology,and parameters with statistical significance were selected.The diagnostic performance of various models,including preoperative clinicopathological variables(model 1),preoperative clinicopathological variables+mp-MRI(model 2),and preoperative clinicopathological variables+mp-MRI+SWE(model 3),was evaluated with area under the receiver operator characteristic curve(AUC)analysis.Emax was significantly higher in prostate cancer with Extracapsular extension(ECE)or seminal vesicle invasion(SVI)with both P<0.001.The optimal cutoff Emax values for ECE and SVI were 60.45 kPa and 81.55 kPa,respectively.Inclusion of mp-MRI and SWE improved discrimination by clinical models for ECE(model 2 vs model 1,P=0.031;model 3 vs model 1,P=0.002;model 3 vs model 2,P=0.018)and SVI(model 2 vs model 1,P=0.147;model 3 vs model 1,P=0.037;model 3 vs model 2,P=0.134).SWE is valuable for identifying patients at high risk of adverse pathology.

关键词： Extracapsular extension prostate cancer seminal vesicle invasion shear-wave elastography transrectal ultrasound

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Validation of user-friendly models predicting Extracapsular extension in prostate cancer patients

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Asian Journal of Urology 2023年第1期10卷 81-88页

作者： Leandro Blas Masaki Shiota Shohei Nagakawa Shigehiro Tsukahara Takashi Matsumoto Ken Lee Keisuke Monji Eiji Kashiwagi Junichi Inokuchi Masatoshi Eto Department of Urology Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

Objective:There are many models to predict Extracapsular extension(ECE)in patients with prostate cancer.We aimed to externally validate several models in a Japanese cohort.Methods:We included patients treated with robotic-assisted radical prostatectomy for prostate cancer.The risk of ECE was calculated for each patient in several models(prostate side-specific and non-side-specific).Model performance was assessed by calculating the receiver operating curve and the area under the curve(AUC),calibration plots,and decision curve analyses.Results:We identified ECE in 117(32.9%)of the 356 prostate lobes included.Patients with ECE had a statistically significant higher prostate-specific antigen level,percentage of positive digital rectal examination,percentage of hypoechoic nodes,percentage of magnetic resonance imaging nodes or ECE suggestion,percentage of biopsy positive cores,International Society of Urological Pathology grade group,and percentage of core involvement.Among the sidespecific models,the Soeterik,Patel,Sayyid,Martini,and Steuber models presented AUC of 0.81,0.78,0.77,0.75,and 0.73,respectively.Among the non-side-specific models,the memorial Sloan Kettering Cancer Center web calculator,the Roach formula,the Partin tables of 2016,2013,and 2007 presented AUC of 0.74,0.72,0.64,0.61,and 0.60,respectively.However,the 95%confidence interval for most of these models overlapped.The side-specific models presented adequate calibration.In the decision curve analyses,most models showed net benefit,but it overlapped among them.Conclusion:Models predicting ECE were externally validated in Japanese men.The side-specific models predicted better than the non-side-specific models.The Soeterik and Patel models were the most accurate performing models.

关键词： Prognosis Prostate cancer Nomogram Extracapsular extension

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Multi-parametric MRI of the prostate:Factors predicting Extracapsular extension at the time of radical prostatectomy

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Asian Journal of Urology 2017年第1期4卷 31-36页

作者： Geoffrey S.Gaunay Vinay Patel Paras Shah Daniel Moreira Ardeshir R.Rastinehad Eran Ben-Levi Robert Villani Manish A.Vira The Smith Institute for Urology Hofstra Northwell School of MedicineNew Hyde ParkNYUSA Department of Urology Mayo ClinicRochesterMNUSA Department of Urology Icahn School of Medicine at Mount SinaiNew YorkNYUSA Department of Radiology Hofstra Northwell School of MedicineNew Hyde ParkNYUSA

Objective:Extracapsular extension(ECE)of prostate cancer is a poor prognostic factor associated with progression,recurrence after treatment,and increased prostate cancer-related mortality.Accurate staging prior to radical prostatectomy is crucial in avoidance of positive margins and when planning nerve-sparing procedures.Multi-parametric magnetic resonance imaging(mpMRI)of the prostate has shown promise in this regard,but is hampered by poor sensitivity.We sought to identify additional clinical variables associated with pathologic ECE and determine our institutional accuracy in the detection of ECE amongst patients who went on to radical prostatectomy.Methods:mpMRI studies performed between the years 2012 and 2014 were cross-referenced with radical prostatectomy specimens.Predictive properties of ECE as well as additional clinical and biochemical variables to identify pathology-proven prostate cancer ECE were analyzed.Results:The prevalence of ECE was 32.4%,and the overall accuracy of mpMRI for ECE was 84.1%.Overall mpMRI sensitivity,specificity,positive predictive value,and negative predictive value for detection of ECE were 58.3%,97.8%,93.3%,and 81.5%,respectively.Specific mpMRI characteristics predictive of pathologic ECE included primary lesion size((20.73±9.09)mm,mean±SD,p<0.001),T2 PIRADS score(p=0.009),overall primary lesion score(p<0.001),overall study suspicion score(p=0.003),and MRI evidence of seminal vesicle invasion(SVI)(p=0.001).

关键词： Prostate cancer Magnetic resonance imaging Staging Prostatectomy Extracapsular extension

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Locally advanced and high risk prostate cancer:The best indication for initial radical prostatectomy?

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Asian Journal of Urology 2014年第1期1卷 40-45页

作者： Hendrik van Poppel Department of Urology University Hospitals LeuvenLeuvenBelgium

High risk prostate cancer is a deadly disease that needs aggressive treatment.High risk prostate cancer is often treated with androgen deprivation therapy or combined radiohormonotherapy while there is a place for surgery in cases of operable and resectable locally advanced or high risk disease.This review summarises the results of the different treatment strategies for locally advanced and high risk prostate cancer.Radical prostatectomy monotherapy or in combination with radiotherapy and/or hormonal treatment are analysed.They show that radical prostatectomy is an effective treatment modality for these tumours.After surgery,the results of the pathology and the follow-up of serum PSA may indicate the need of additional adjuvant or salvage treatment strategies.

关键词： Prostate cancer High risk Radical prostatectomy Extracapsular extension High-grade prostate cancer

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