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01-05-2018 | Urogenital

Preoperative multiparametric MRI of the prostate for the prediction of lymph node metastases in prostate cancer patients treated with extended pelvic lymph node dissection

Authors: Giorgio Brembilla, Paolo Dell’Oglio, Armando Stabile, Alessandro Ambrosi, Giulia Cristel, Lisa Brunetti, Anna Damascelli, Massimo Freschi, Antonio Esposito, Alberto Briganti, Francesco Montorsi, Alessandro Del Maschio, Francesco De Cobelli

Published in: European Radiology | Issue 5/2018

Abstract

Objectives

To assess the role of preoperative multiparametric MRI (mpMRI) of the prostate in the prediction of nodal metastases in patients treated with radical prostatectomy (RP) and extended pelvic lymph node dissection (ePLND).

Methods

We retrospectively analyzed 101 patients who underwent both preoperative mpMRI of the prostate and RP with ePLND at our institution. For each patient, complete preoperative clinical data and tumour characteristics at mpMRI were recorded. Final histopathologic stage was considered the standard of reference. Univariate and multivariate logistic regression analyses were performed.

Results

Nodal metastases were found in 23/101 (22.8%) patients. At univariate analyses, all clinical and radiological parameters were significantly associated to nodal invasion (all p<0.03); tumour volume at MRI (mrV), tumour ADC and tumour T-stage at MRI (mrT) were the most accurate predictors (AUC = 0.93, 0.86 and 0.84, respectively). A multivariate model including PSA levels, primary Gleason grade, mrT and mrV showed high predictive accuracy (AUC = 0.956). Observed prevalence of nodal metastases was very low among tumours with mrT2 stage and mrV<1cc (1.8%).

Conclusion

Preoperative mpMRI of the prostate can predict nodal metastases in prostate cancer patients, potentially allowing a better selection of candidates to ePLND.

Key points

• Multiparametric-MRI of the prostate can predict nodal metastases in prostate cancer

• Tumour volume and stage at MRI are the most accurate predictors

• Prevalence of nodal metastases is low for T2-stage and <1cc tumours

• Preoperative mpMRI may allow a better selection of candidates to lymphadenectomy

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Title: Preoperative multiparametric MRI of the prostate for the prediction of lymph node metastases in prostate cancer patients treated with extended pelvic lymph node dissection
Authors: Giorgio Brembilla
Paolo Dell’Oglio
Armando Stabile
Alessandro Ambrosi
Giulia Cristel
Lisa Brunetti
Anna Damascelli
Massimo Freschi
Antonio Esposito
Alberto Briganti
Francesco Montorsi
Alessandro Del Maschio
Francesco De Cobelli
Publication date: 01-05-2018
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 5/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-5229-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Preoperative multiparametric MRI of the prostate for the prediction of lymph node metastases in prostate cancer patients treated with extended pelvic lymph node dissection

Abstract

Objectives

Methods

Results

Conclusion

Key points

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key points

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