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Multicenter Study
. 2024 Sep 20;42(1):530.
doi: 10.1007/s00345-024-05232-6.

Bicenter validation of a risk model for the preoperative prediction of extraprostatic extension of localized prostate cancer combining clinical and multiparametric MRI parameters

Nicola Edith von Ostau #  1 , Analena Elisa Handke #  2   3 , Manuel Wiesenfarth  4 , Peter Albers  5 , Gerald Antoch  6 , Joachim Noldus  3 , Henning Reis  7 , Cristina Cotarelo  8   9 , Julia Preetz  8 , Lale Umutlu  10 , Marc Ingenwerth  11 , Jan Philipp Radtke  2   5   12 , Boris Hadaschik  2 , Lars Schimmöller #  6   13 , Claudia Kesch #  2
Affiliations
Multicenter Study

Bicenter validation of a risk model for the preoperative prediction of extraprostatic extension of localized prostate cancer combining clinical and multiparametric MRI parameters

Nicola Edith von Ostau et al. World J Urol. .

Abstract

Background: This study aimed to validate a previously published risk model (RM) which combines clinical and multiparametric MRI (mpMRI) parameters to predict extraprostatic extension (EPE) of prostate cancer (PC) prior to radical prostatectomy (RP).

Materials and methods: A previously published RM combining clinical with mpMRI parameters including European Society of Urogenital Radiology (ESUR) classification for EPE was retrospectively evaluated in a cohort of two urological university hospitals in Germany. Consecutive patients (n = 205, January 2015 -June 2021) with available preoperative MRI images, clinical information including PSA, prostate volume, ESUR classification for EPE, histopathological results of MRI-fusion biopsy and RP specimen were included. Validation was performed by receiver operating characteristic analysis and calibration plots. The RM's performance was compared to ESUR criteria.

Results: Histopathological T3 stage was detected in 43% of the patients (n = 89); 45% at Essen and 42% at Düsseldorf. Discrimination performance between pT2 and pT3 of the RM in the entire cohort was AUC = 0.86 (AUC = 0.88 at site 1 and AUC = 0.85 at site 2). Calibration was good over the entire probability range. The discrimination performance of ESUR classification alone was comparable (AUC = 0.87).

Conclusions: The RM showed good discriminative performance to predict EPE for decision-making for RP as a patient-tailored risk stratification. However, when experienced MRI reading is available, standardized MRI reading with ESUR scoring is comparable regarding information outcome. A main limitation is the potentially limited transferability to other populations because of the high prevalence of EPE in our subgroups.

Keywords: Extraprostatic extension; Multiparametric MRI; Positive surgical margins; Prostate cancer.

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Conflict of interest statement

Nicola Edith von Ostau congress travel expenses Janssen-Cilag GmbH. Analena Elisa Handke no disclosures. Manuel Wiesenfarth no disclosures. Marc Ingenwerth no disclosures. Henning Reis Honoraria: Roche, Bristol-Myers Squibb, Janssen-Cilag, Novartis, Astra-Zeneca, MCI, CHOP GmbH, Sanofi, Boehringer-Ingelheim, GlaxoSmithKline, Merck, Diaceutics; Advisory boards: Bristol-Myers Squibb, Roche; travel support: Philips, Roche, Bristol-Myers Squibb; funding: Bristol-Myers Squibb. Jan Philipp Radtke: Advisory Boards and Consulting for Astellas, Janssen Pharmaceuticals, Astra Zeneca, Novartis, Saegeling Medizintechnik, Bender Gruppe, Dr Wolf, Beckelmann und Partner. Invited speaker for Apogepha, Astellas, Astra Zeneca, Bayer, Janssen Pharmaceuticals, Novartis, Philips Invivo. Research Funding: AAA/Novartis, Medical Faculty Heinrich-Heine-University Düsseldorf, EAU Research Foundation. Boris Hadaschik: Advisory boards for Astellas, AstraZeneca, Janssen, Bayer, ABX, Lightpoint, Amgen, MSD, Pfizer, Novartis. Invited speaker for Accord, Astellas, Janssen R&D. Honoraria from Uromed. Research funding from AAA/Novartis, Bristol Myers Squibb, and German Research Foundation. Leadership roles for DKG AUO and DGU. Lars Schimmöller no disclosures. Claudia Kesch: Consulting for Apogepha. Invited speaker for Novartis, and Pfizer.Travel support from Janssen R&D, Amgen and Bayer. Research funding from AAA/Novartis, Amgen and Mariana Oncology. All authors declare no conflict of interest regarding this manuscript.

Figures

Fig. 1
Fig. 1
ROC curve analysis of the EPE-RM (black curve) and ESUR (red curve) for the prediction of an EPE. A: Site 1 (Essen); B: Site 2 (Düsseldorf)
See this image and copyright information in PMC

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