Imaging and Pathology Correlations for Different Risk Stratification Models for Intermediate-risk Prostate Cancer

Abstract

Background/aim: We evaluated whether sub-stratifying intermediate-risk (IR) prostate cancer using the Memorial Sloan Kettering Cancer (MSKCC) or Prostate Cancer Risk Stratification (ProCaRS) model predicts for adverse imaging or pathologic features.

Patients and methods: 56 consecutive IR patients who underwent multi-parametric MRI (mpMRI) and radical prostatectomy (RP) were studied. The different groups were tested for correlation with adverse findings. 2-sample T-tests assuming unequal variance were used.

Results: On mpMRI the MSKCC unfavorable group had higher index lesion suspicion scores (p=0.044), while the ProCaRS model showed a higher maximum tumor diameter (MTD) in the high-risk group (p=0.047). At RP, a higher pathologic MTD (23.3 vs. 17.6 mm, p=0.005) was present in the MSKCC unfavorable group as well as the ProCaRS high vs. low group (26.6 vs. 19.3 mm, p=0.022).

Conclusion: Both models demonstrated a correlation with higher MTD for unfavorable IR patients. This is likely a driver of worse clinical outcomes.

Keywords: MSKCC; ProCars; maximal tumor diameter; mpMRI; prostatectomy.