D. Santucci , D. Vertulli , F. Esperto , L. Eolo Trodella , S. Ramella , R. Papalia , R.M. Scarpa , C. de Felice , R. Francesco Grasso , B. Beomonte Zobel , E. Faiella
{"title":"前列腺癌根治性前列腺切除术后复发患者放射治疗前psa水平和病理状态预测mp-MRI结果的作用","authors":"D. Santucci , D. Vertulli , F. Esperto , L. Eolo Trodella , S. Ramella , R. Papalia , R.M. Scarpa , C. de Felice , R. Francesco Grasso , B. Beomonte Zobel , E. Faiella","doi":"10.1016/j.acuroe.2023.11.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate PSA value in mp-MRI results prediction, analyzing patients with high (GS<!--> <!-->≥<!--> <!-->8, pT<!--> <!-->≥<!--> <!-->3, pN1) and low grade (GS<!--> <!--><<!--> <!-->8, pT<!--> <!--><<!--> <!-->3, pN0) Prostate Cancer (PCa).</p></div><div><h3>Materials and methods</h3><p>One hundred eighty-eight patients underwent 1.5-Tmp-MRI after Radical Prostatectomy (RP) and before Radiotherapy (RT). They were divided into 2 groups: A and B, for patients with biochemical recurrence (BCR) and without BCR but with high local recurrence risk. Considering Gleason Score (GS), pT and pN as independent grouping variables, ROC analyses of PSA levels at primary PCa diagnosis and PSA before RT were performed in order to identify the optimal cut-off to predict mp-MRI result.</p></div><div><h3>Results</h3><p>Group A and B showed higher AUC for PSA before RT than PSA at PCa diagnosis, in low and high grade tumors. For low grade tumors the best AUC was 0.646 and 0.685 in group A and B; for high grade the best AUC was 0.705 and 1 in group A and B, respectively. For low grade tumors the best PSA cut-off was 0.565−0.58<!--> <!-->ng/mL in group A (sensitivity, specificity: 70.5%, 66%), and 0.11−0.13<!--> <!-->ng/mL in B (sensitivity, specificity: 62.5%, 84.6%). For high grade tumors, the best PSA cut-off obtained was 0.265−0.305<!--> <!-->ng/mL in group A (sensitivity, specificity: 95%, 42.1%), and 0.13−0.15<!--> <!-->ng/mL in B (sensitivity, specificity: 100%).</p></div><div><h3>Conclusion</h3><p>Mp-MRI should be performed as added diagnostic tool always when a BCR is detected, especially in high grade PCa. In patients without BCR, mp-MRI results, although poorly related to pathological stadiation, still have a good diagnostic performance, mostly when PSA<!--> <!-->><!--> <!-->0.1−0.15<!--> <!-->ng/mL.</p></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Role of psa levels and pathological stadiation before radiation therapy in predicting mp-MRI results in patients with prostate cancer recurrence after radical prostatectomy\",\"authors\":\"D. Santucci , D. Vertulli , F. Esperto , L. Eolo Trodella , S. Ramella , R. Papalia , R.M. Scarpa , C. de Felice , R. Francesco Grasso , B. Beomonte Zobel , E. Faiella\",\"doi\":\"10.1016/j.acuroe.2023.11.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To evaluate PSA value in mp-MRI results prediction, analyzing patients with high (GS<!--> <!-->≥<!--> <!-->8, pT<!--> <!-->≥<!--> <!-->3, pN1) and low grade (GS<!--> <!--><<!--> <!-->8, pT<!--> <!--><<!--> <!-->3, pN0) Prostate Cancer (PCa).</p></div><div><h3>Materials and methods</h3><p>One hundred eighty-eight patients underwent 1.5-Tmp-MRI after Radical Prostatectomy (RP) and before Radiotherapy (RT). They were divided into 2 groups: A and B, for patients with biochemical recurrence (BCR) and without BCR but with high local recurrence risk. Considering Gleason Score (GS), pT and pN as independent grouping variables, ROC analyses of PSA levels at primary PCa diagnosis and PSA before RT were performed in order to identify the optimal cut-off to predict mp-MRI result.</p></div><div><h3>Results</h3><p>Group A and B showed higher AUC for PSA before RT than PSA at PCa diagnosis, in low and high grade tumors. For low grade tumors the best AUC was 0.646 and 0.685 in group A and B; for high grade the best AUC was 0.705 and 1 in group A and B, respectively. For low grade tumors the best PSA cut-off was 0.565−0.58<!--> <!-->ng/mL in group A (sensitivity, specificity: 70.5%, 66%), and 0.11−0.13<!--> <!-->ng/mL in B (sensitivity, specificity: 62.5%, 84.6%). For high grade tumors, the best PSA cut-off obtained was 0.265−0.305<!--> <!-->ng/mL in group A (sensitivity, specificity: 95%, 42.1%), and 0.13−0.15<!--> <!-->ng/mL in B (sensitivity, specificity: 100%).</p></div><div><h3>Conclusion</h3><p>Mp-MRI should be performed as added diagnostic tool always when a BCR is detected, especially in high grade PCa. In patients without BCR, mp-MRI results, although poorly related to pathological stadiation, still have a good diagnostic performance, mostly when PSA<!--> <!-->><!--> <!-->0.1−0.15<!--> <!-->ng/mL.</p></div>\",\"PeriodicalId\":94291,\"journal\":{\"name\":\"Actas urologicas espanolas\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Actas urologicas espanolas\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2173578623001294\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Actas urologicas espanolas","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2173578623001294","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Role of psa levels and pathological stadiation before radiation therapy in predicting mp-MRI results in patients with prostate cancer recurrence after radical prostatectomy
Objective
To evaluate PSA value in mp-MRI results prediction, analyzing patients with high (GS ≥ 8, pT ≥ 3, pN1) and low grade (GS < 8, pT < 3, pN0) Prostate Cancer (PCa).
Materials and methods
One hundred eighty-eight patients underwent 1.5-Tmp-MRI after Radical Prostatectomy (RP) and before Radiotherapy (RT). They were divided into 2 groups: A and B, for patients with biochemical recurrence (BCR) and without BCR but with high local recurrence risk. Considering Gleason Score (GS), pT and pN as independent grouping variables, ROC analyses of PSA levels at primary PCa diagnosis and PSA before RT were performed in order to identify the optimal cut-off to predict mp-MRI result.
Results
Group A and B showed higher AUC for PSA before RT than PSA at PCa diagnosis, in low and high grade tumors. For low grade tumors the best AUC was 0.646 and 0.685 in group A and B; for high grade the best AUC was 0.705 and 1 in group A and B, respectively. For low grade tumors the best PSA cut-off was 0.565−0.58 ng/mL in group A (sensitivity, specificity: 70.5%, 66%), and 0.11−0.13 ng/mL in B (sensitivity, specificity: 62.5%, 84.6%). For high grade tumors, the best PSA cut-off obtained was 0.265−0.305 ng/mL in group A (sensitivity, specificity: 95%, 42.1%), and 0.13−0.15 ng/mL in B (sensitivity, specificity: 100%).
Conclusion
Mp-MRI should be performed as added diagnostic tool always when a BCR is detected, especially in high grade PCa. In patients without BCR, mp-MRI results, although poorly related to pathological stadiation, still have a good diagnostic performance, mostly when PSA > 0.1−0.15 ng/mL.