Korean J Radiol.  2019 Feb;20(2):256-264. 10.3348/kjr.2018.0613.

Prognostic Significance for Long-Term Outcomes Following Radical Prostatectomy in Men with Prostate Cancer: Evaluation with Prostate Imaging Reporting and Data System Version 2

• Kim R
• Kim CK
• Park JJ
• Kim JH
• Seo SI
• Jeon SS
• Lee HM

• KMID: 2438256
• DOI: http://doi.org/10.3348/kjr.2018.0613

Abstract

OBJECTIVE
To retrospectively determine whether the use of the Prostate Imaging Reporting and Data System (PI-RADS) version 2 (v2) helps predict long-term outcomes for prostate cancer (PCa) patients following radical prostatectomy (RP).
MATERIALS AND METHODS
A total of 166 patients with localized PCa evaluated with multiparametric magnetic resonance imaging (mpMRI) at 3T before RP were enrolled. Three groups were created based on PI-RADS v2 score used to predict clinical outcomes: group A, ≥ 3; group B, ≥ 4; group C, 5. We calculated biochemical recurrence-free survival (RFS) and progression-free survival (PFS). Cox proportion hazards models were used to identify variables predictive of biochemical recurrence and disease progression.
RESULTS
During a median follow-up of 9.1 years, biochemical recurrence occurred in 67 patients (40.4%) and disease progression occurred in 55 patients (33.1%). In all groups, 10-year RFS and 10-year PFS were significantly lower for PI-RADS scores ≥ 3, ≥ 4 and 5 than for score < 3, < 4 and < 5 (p <0.05), respectively. In multivariate analysis, PI-RADS score ≥ 3 and score 5 were significant independent risk marker for biochemical recurrence (hazard ratio [HR] = 5.58, p = 0.018; HR = 1.75, p = 0.033) and disease progression (HR = 3.99, p = 0.047; HR = 2.31, p = 0.040). Moderate inter-observer agreement was seen for PI-RADS scoring.
CONCLUSION
PI-RADS v2 may be used to predict long-term outcomes following RP in PCa.

Keyword

Prostate cancer; Prostatectomy; Prognosis; PI-RADS; Outcome

MeSH Terms

Disease Progression
Disease-Free Survival
Follow-Up Studies
Humans
Information Systems*
Magnetic Resonance Imaging
Male
Multivariate Analysis
Passive Cutaneous Anaphylaxis
Prognosis
Proportional Hazards Models
Prostate*
Prostatectomy*
Prostatic Neoplasms*
Recurrence
Retrospective Studies

Figure

• 

  Fig. 1 Flow diagram of patient enrollment.mpMRI = multiparametric magnetic resonance imaging, PCa = prostate cancer

• 

  Fig. 2 Kaplan-Meier and log-rank test estimates of probability of RFS (A–C) and PFS (D–F) for PCa following radical prostatectomy, according to PI-RADS v2 score with < 3 versus ≥ 3 (A, D), < 4 versus ≥ 4 (B, E), and < 5 versus 5 (C, F).mo = month, PFS = progression-free survival, RFS = biochemical recurrence-free survival, PI-RADS v2 = Prostate Imaging and Reporting and Data System version 2, yrs = years

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