Login Register Cart 0
Generic placeholder image

Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Assessment of Diagnostic Performance of Risk Factors Affecting Extraprostatic Extension: Role of Zonal Level of Prostate Cancer

Author(s): Seo Young Park* and Ga Young Jeon

Volume 20, 2024

Published on: 11 October, 2023

Article ID: e080923220826 Pages: 9

DOI: 10.2174/1573405620666230908111737

open_access

Abstract

Objective: Extraprostatic extension (EPE) serves as a crucial marker of prostate cancer aggressiveness and independently predicts the likelihood of biochemical recurrence (BCR), exhibiting a strong correlation with the histologic severity of EPE. Therefore, this study aimed to investigate the probability of EPE along the zonal level of the prostate by measuring tumor contact length (TCL) using multiparametric magnetic resonance imaging (mpMRI).

Patients and Methods: Records of 308 patients who had undergone radical prostatectomy (RP) were identified. Tumor levels in the prostate were categorized as apex, mid-gland, and base, after which the correlation between TCL measured using MRI and microscopic EPE on pathologic specimens was evaluated. Univariable and multivariable logistic regression analyses were performed to assess the association among tumor origin, index tumor diameter, and TCL measured using MRI and microscopic EPE in RP specimens.

Results: Among the 214 patients included, 45 apical cancers (21%), 87 mid-gland cancers (41%), and 82 base cancers (38%) were observed. Pathological reports revealed that 18 (40.0%) apex, 31 (35.6%) mid-gland, and 50 (61.0%) base tumors were pT3a. Multivariable analysis demonstrated that the zonal level of the tumor, especially the base level, was an independent predictive factor for EPE (P < 0.001), and the AUC value of the base tumor was 0.858.

Conclusion: Prostate cancers arising from the base were more likely to exhibit EPE than those arising from the mid-gland and apex of the prostate gland. Therefore, identifying the origin of the zonal level of prostate cancer may help guide treatment decisions and predict clinical prognosis.

Keywords: Prostate, Neoplasms, Magnetic resonance imaging, Neoplasm staging, Extraprostatic extension.

[1]
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68(6): 394-424.
[http://dx.doi.org/10.3322/caac.21492] [PMID: 30207593]
[2]
Catalona WJ, Bigg SW. Nerve-sparing radical prostatectomy: Evaluation of results after 250 patients. J Urol 1990; 143(3): 538-43.
[http://dx.doi.org/10.1016/S0022-5347(17)40013-9] [PMID: 2304166]
[3]
Ball MW, Partin AW, Epstein JI. Extent of extraprostatic extension independently influences biochemical recurrence-free survival: Evidence for further pT3 subclassification. Urology 2015; 85(1): 161-4.
[http://dx.doi.org/10.1016/j.urology.2014.08.025] [PMID: 25440818]
[4]
Rosenkrantz AB, Shanbhogue AK, Wang A, Kong MX, Babb JS, Taneja SS. Length of capsular contact for diagnosing extraprostatic extension on prostate MRI: Assessment at an optimal threshold. J Magn Reson Imaging 2016; 43(4): 990-7.
[http://dx.doi.org/10.1002/jmri.25040] [PMID: 26395278]
[5]
Matsumoto K, Akita H, Narita K, et al. Prediction of extraprostatic extension by MRI tumor contact length: Difference between anterior and posterior prostate cancer. Prostate Cancer Prostatic Dis 2019; 22(4): 539-45.
[http://dx.doi.org/10.1038/s41391-019-0136-3] [PMID: 30814680]
[6]
Touma NJ, Chin JL, Bella T, Sener A, Izawa J. Location of a positive biopsy as a predictor of surgical margin status and extraprostatic disease in radical prostatectomy. BJU Int 2006; 97(2): 259-62.
[http://dx.doi.org/10.1111/j.1464-410X.2006.05968.x] [PMID: 16430624]
[7]
Bhavsar A, Verma S. Anatomic imaging of the prostate. BioMed Res Int 2014; 2014: 1-9.
[http://dx.doi.org/10.1155/2014/728539] [PMID: 25243174]
[8]
Turkbey B, Rosenkrantz AB, Haider MA, et al. Prostate imaging reporting and data system version 2.1: 2019 update of prostate imaging reporting and data system version 2. Eur Urol 2019; 76(3): 340-51.
[http://dx.doi.org/10.1016/j.eururo.2019.02.033] [PMID: 30898406]
[9]
Epstein JI, Egevad L, Amin MB, Delahunt B, Srigley JR, Humphrey PA. The 2014 International Society of Urological Pathology (ISUP) consensus conference on gleason grading of prostatic carcinoma: definition of grading patterns and proposal for a new grading system. Am J Surg Pathol 2016; 40(2): 244-52.
[http://dx.doi.org/10.1097/PAS.0000000000000530] [PMID: 26492179]
[10]
Cohen J. Weighted kappa: Nominal scale agreement provision for scaled disagreement or partial credit. Psychol Bull 1968; 70(4): 213-20.
[http://dx.doi.org/10.1037/h0026256] [PMID: 19673146]
[11]
Mottet N, van den Bergh RCN, Briers E, et al. EAU-EANM-ESTRO-ESUR-SIOG guidelines on prostate cancer-2020 Update. Part 1: Screening, diagnosis, and local treatment with curative intent. Eur Urol 2021; 79(2): 243-62.
[http://dx.doi.org/10.1016/j.eururo.2020.09.042] [PMID: 33172724]
[12]
Matsuoka Y, Ishioka J, Tanaka H, et al. Impact of the prostate imaging reporting and data system, version 2, on MRI diagnosis for extracapsular extension of prostate cancer. AJR Am J Roentgenol 2017; 209(2): W76-84.
[http://dx.doi.org/10.2214/AJR.16.17163] [PMID: 28570124]
[13]
Allan C, Ilic D. Laparoscopic versus robotic-assisted radical prostatectomy for the treatment of localised prostate cancer: A systematic review. Urol Int 2016; 96(4): 373-8.
[http://dx.doi.org/10.1159/000435861] [PMID: 26201500]
[14]
Budäus L, Spethmann J, Isbarn H, et al. Inverse stage migration in patients undergoing radical prostatectomy: Results of 8916 European patients treated within the last decade. BJU Int 2011; 108(8): 1256-61.
[http://dx.doi.org/10.1111/j.1464-410X.2010.09982.x] [PMID: 21244612]
[15]
Ward JF, Slezak JM, Blute ML, Bergstralh EJ, Zincke H. Radical prostatectomy for clinically advanced (cT3) prostate cancer since the advent of prostate-specific antigen testing: 15-year outcome. BJU Int 2005; 95(6): 751-6.
[http://dx.doi.org/10.1111/j.1464-410X.2005.05394.x] [PMID: 15794776]
[16]
Krishna S, Lim CS, McInnes MDF, et al. Evaluation of MRI for diagnosis of extraprostatic extension in prostate cancer. J Magn Reson Imaging 2018; 47(1): 176-85.
[http://dx.doi.org/10.1002/jmri.25729] [PMID: 28387981]
[17]
Ukimura O, Troncoso P, Ramirez E, Babaian RJ. Prostate cancer staging: Correlation between ultrasound determined tumor contact length and pathologically confirmed extraprostatic extension. J Urol 1998; 159(4): 1251-9.
[http://dx.doi.org/10.1016/S0022-5347(01)63575-4] [PMID: 9507847]
[18]
Baco E, Rud E, Vlatkovic L, et al. Predictive value of magnetic resonance imaging determined tumor contact length for extracapsular extension of prostate cancer. J Urol 2015; 193(2): 466-72.
[http://dx.doi.org/10.1016/j.juro.2014.08.084] [PMID: 25150643]
[19]
Wibulpolprasert P, Raman SS, Hsu W, et al. Influence of the location and zone of tumor in prostate cancer detection and localization on 3-T multiparametric MRI based on PI-RADS version 2. AJR Am J Roentgenol 2020; 214(5): 1101-11.
[http://dx.doi.org/10.2214/AJR.19.21608] [PMID: 32130048]
[20]
Lee YI, Lee HM, Jo JK, et al. Association between seminal vesicle invasion and prostate cancer detection location after transrectal systemic biopsy among men who underwent radical prostatectomy. PLoS One 2016; 11(2): e0148690.
[http://dx.doi.org/10.1371/journal.pone.0148690] [PMID: 26848747]
[21]
Blute ML, Bostwick DG, Bergstralh EJ, et al. Anatomic site-specific positive margins in organconfined prostate cancer and its impact on outcome after radical prostatectomy. Urology 1997; 50(5): 733-9.
[http://dx.doi.org/10.1016/S0090-4295(97)00450-0] [PMID: 9372884]
[22]
Naya Y, Babaian RJ. The predictors of pelvic lymph node metastasis at radical retropubic prostatectomy. J Urol 2003; 170(6): 2306-10.
[http://dx.doi.org/10.1097/01.ju.0000097180.98966.06] [PMID: 14634402]
[23]
Koh H, Kattan MW, Scardino PT, et al. A nomogram to predict seminal vesicle invasion by the extent and location of cancer in systematic biopsy results. J Urol 2003; 170(4 Part 1): 1203-8.
[http://dx.doi.org/10.1097/01.ju.0000085074.62960.7b] [PMID: 14501725]
[24]
Fine SW, Al-Ahmadie HA, Gopalan A, Tickoo SK, Scardino PT, Reuter VE. Anatomy of the anterior prostate and extraprostatic space: A contemporary surgical pathology analysis. Adv Anat Pathol 2007; 14(6): 401-7.
[http://dx.doi.org/10.1097/PAP.0b013e3181597a9c] [PMID: 18049129]
[25]
McNeal JE, Haillot O. Patterns of spread of adenocarcinoma in the prostate as related to cancer volume. Prostate 2001; 49(1): 48-57.
[http://dx.doi.org/10.1002/pros.1117] [PMID: 11550210]
[26]
Villers A, McNeal JE, Redwine EA, Freiha FS, Stamey TA. The role of perineural space invasion in the local spread of prostatic adenocarcinoma. J Urol 1989; 142(3): 763-8.
[http://dx.doi.org/10.1016/S0022-5347(17)38881-X] [PMID: 2769857]
[27]
McNeal JE, Redwine EA, Freiha FS, Stamey TA. Zonal distribution of prostatic adenocarcinoma. Correlation with histologic pattern and direction of spread. Am J Surg Pathol 1988; 12(12): 897-906.
[http://dx.doi.org/10.1097/00000478-198812000-00001] [PMID: 3202246]
[28]
Chen C, Shen J, Xing Z, et al. Significance of examined lymph-node count in accurate staging and long-term survival in patients undergoing radical prostatectomy: A population-based study. Int Urol Nephrol 2020; 52(2): 271-8.
[http://dx.doi.org/10.1007/s11255-019-02300-4] [PMID: 31571158]

Rights & Permissions Print Cite
Article Metrics
19
2
© 2024 Bentham Science Publishers | Privacy Policy