Matthew J. Roberts, Nathan Papa, Hans Veerman, Katelijne de Bie, Andrew Morton, Anthony Franklin, Sheliyan Raveenthiran, William J. Yaxley, Maarten L. Donswijk, Henk G. van der Poel, Hemamali Samaratunga, David Wong, Nicholas Brown, Robert Parkinson, Troy Gianduzzo, Boon Kua, Geoffrey D. Coughlin, Daniela E. Oprea-Lager, Louise Emmett, Pim J. van Leeuwen, John W. Yaxley, André N. Vis
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Vis","doi":"10.1111/bju.16482","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Objectives</h3>\n \n <p>To construct and externally calibrate a predictive model for early biochemical recurrence (BCR) after radical prostatectomy (RP) incorporating clinical and modern imaging characteristics of the primary tumour.</p>\n </section>\n \n <section>\n \n <h3> Patients and Methods</h3>\n \n <p>Patients who underwent RP following multiparametric magnetic resonance imaging, prostate biopsy and prostate-specific membrane antigen-positron emission tomography/computed tomography (PSMA-PET/CT), from two centres in Australia and the Netherlands. The primary outcome was biochemical recurrence-free survival (BRFS), where BCR was defined as a rising PSA level of ≥0.2 ng/mL or initiation of postoperative treatment per clinician discretion. Proportional hazards models to predict time to event were developed in the Australian sample using relevant pre- and post-surgical parameters and primary tumour maximum standardised uptake value (SUV<sub>max</sub>) on diagnostic PSMA-PET/CT. Calibration was assessed in an external dataset from the Netherlands with the same inclusion criteria.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Data from 846 patients were used to develop the models. Tumour SUV<sub>max</sub> was associated with worse predicted 3-year BRFS for both pre- and post-surgical models. SUV<sub>max</sub> change from 4 to 16 lessened the predicted 3-year BRFS from 66% to 42% for a patient aged 65 years with typical pre-surgical parameters (PSA level 8 ng/mL, Prostate Imaging-Reporting and Data System score 4/5 and biopsy Gleason score ≥4 + 5). Considering post-surgical variables, a patient with the same age and PSA level but pathological stage pT3a, RP Gleason score ≥4 + 5 and negative margins, SUV<sub>max</sub> change from 4 to 16 lessened the predicted 3-year BRFS from 76% to 61%. Calibration on an external sample (<i>n</i> = 464) showed reasonable performance; however, a tendency to overestimate survival in patients with good prognostic factors was observed.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Tumour SUV<sub>max</sub> on diagnostic PSMA-PET/CT has utility additional to commonly recognised variables for prediction of BRFS after RP.</p>\n </section>\n </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"134 S2","pages":"47-55"},"PeriodicalIF":3.7000,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.16482","citationCount":"0","resultStr":"{\"title\":\"Prediction of biochemical recurrence after radical prostatectomy from primary tumour characteristics\",\"authors\":\"Matthew J. Roberts, Nathan Papa, Hans Veerman, Katelijne de Bie, Andrew Morton, Anthony Franklin, Sheliyan Raveenthiran, William J. Yaxley, Maarten L. Donswijk, Henk G. van der Poel, Hemamali Samaratunga, David Wong, Nicholas Brown, Robert Parkinson, Troy Gianduzzo, Boon Kua, Geoffrey D. Coughlin, Daniela E. Oprea-Lager, Louise Emmett, Pim J. van Leeuwen, John W. Yaxley, André N. Vis\",\"doi\":\"10.1111/bju.16482\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>To construct and externally calibrate a predictive model for early biochemical recurrence (BCR) after radical prostatectomy (RP) incorporating clinical and modern imaging characteristics of the primary tumour.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Patients and Methods</h3>\\n \\n <p>Patients who underwent RP following multiparametric magnetic resonance imaging, prostate biopsy and prostate-specific membrane antigen-positron emission tomography/computed tomography (PSMA-PET/CT), from two centres in Australia and the Netherlands. The primary outcome was biochemical recurrence-free survival (BRFS), where BCR was defined as a rising PSA level of ≥0.2 ng/mL or initiation of postoperative treatment per clinician discretion. Proportional hazards models to predict time to event were developed in the Australian sample using relevant pre- and post-surgical parameters and primary tumour maximum standardised uptake value (SUV<sub>max</sub>) on diagnostic PSMA-PET/CT. Calibration was assessed in an external dataset from the Netherlands with the same inclusion criteria.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Data from 846 patients were used to develop the models. Tumour SUV<sub>max</sub> was associated with worse predicted 3-year BRFS for both pre- and post-surgical models. SUV<sub>max</sub> change from 4 to 16 lessened the predicted 3-year BRFS from 66% to 42% for a patient aged 65 years with typical pre-surgical parameters (PSA level 8 ng/mL, Prostate Imaging-Reporting and Data System score 4/5 and biopsy Gleason score ≥4 + 5). Considering post-surgical variables, a patient with the same age and PSA level but pathological stage pT3a, RP Gleason score ≥4 + 5 and negative margins, SUV<sub>max</sub> change from 4 to 16 lessened the predicted 3-year BRFS from 76% to 61%. 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Prediction of biochemical recurrence after radical prostatectomy from primary tumour characteristics
Objectives
To construct and externally calibrate a predictive model for early biochemical recurrence (BCR) after radical prostatectomy (RP) incorporating clinical and modern imaging characteristics of the primary tumour.
Patients and Methods
Patients who underwent RP following multiparametric magnetic resonance imaging, prostate biopsy and prostate-specific membrane antigen-positron emission tomography/computed tomography (PSMA-PET/CT), from two centres in Australia and the Netherlands. The primary outcome was biochemical recurrence-free survival (BRFS), where BCR was defined as a rising PSA level of ≥0.2 ng/mL or initiation of postoperative treatment per clinician discretion. Proportional hazards models to predict time to event were developed in the Australian sample using relevant pre- and post-surgical parameters and primary tumour maximum standardised uptake value (SUVmax) on diagnostic PSMA-PET/CT. Calibration was assessed in an external dataset from the Netherlands with the same inclusion criteria.
Results
Data from 846 patients were used to develop the models. Tumour SUVmax was associated with worse predicted 3-year BRFS for both pre- and post-surgical models. SUVmax change from 4 to 16 lessened the predicted 3-year BRFS from 66% to 42% for a patient aged 65 years with typical pre-surgical parameters (PSA level 8 ng/mL, Prostate Imaging-Reporting and Data System score 4/5 and biopsy Gleason score ≥4 + 5). Considering post-surgical variables, a patient with the same age and PSA level but pathological stage pT3a, RP Gleason score ≥4 + 5 and negative margins, SUVmax change from 4 to 16 lessened the predicted 3-year BRFS from 76% to 61%. Calibration on an external sample (n = 464) showed reasonable performance; however, a tendency to overestimate survival in patients with good prognostic factors was observed.
Conclusion
Tumour SUVmax on diagnostic PSMA-PET/CT has utility additional to commonly recognised variables for prediction of BRFS after RP.
期刊介绍：
BJUI is one of the most highly respected medical journals in the world, with a truly international range of published papers and appeal. Every issue gives invaluable practical information in the form of original articles, reviews, comments, surgical education articles, and translational science articles in the field of urology. BJUI employs topical sections, and is in full colour, making it easier to browse or search for something specific.
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