Prostate magnetic resonance imaging findings in patients treated for testosterone deficiency while on active surveillance for low-risk prostate cancer

被引:7
作者
Hashimoto, Takeshi [1 ,4 ]
Rahul, Krishnan [2 ]
Takeda, Toshikazu [1 ]
Benfante, Nicole [1 ]
Mulhall, John P. [2 ]
Hricak, Hedvig [3 ]
Eastham, James A. [1 ]
Vargas, Hebert Alberto [3 ]
机构
[1] Mem Sloan Kettering Canc Ctr, Dept Surg, Urol Serv, New York, NY 10021 USA
[2] Mem Sloan Kettering Canc, Urol Serv, Sexual & Reprod Med Program, New York, NY USA
[3] Mem Sloan Kettering Canc Ctr, Dept Radiol, 1275 York Ave, New York, NY 10021 USA
[4] Tokyo Med Univ, Dept Urol, Tokyo, Japan
关键词
Active surveillance; Multiparametric prostate magnetic resonance imaging; Prostate cancer; Testosterone deficiency; Testosterone replacement therapy; ANDROGEN-DEPRIVATION THERAPY; REPLACEMENT THERAPY; MEN; MANAGEMENT; COHORT; CARE; MRI;
D O I
10.1016/j.urolonc.2016.07.004
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objective: To investigate the multiparametric prostate magnetic resonance imaging (mpMRI) findings in patients treated with testosterone replacement therapy (TRT) while on active surveillance for low-risk prostate cancer. Methods: We retrospectively reviewed 12 patients who underwent mpMRI before and after TRT while on active surveillance. Changes in serum testosterone level, prostate-specific antigen (PSA), prostate biopsy findings, prostate volume, and Prostate Imaging Reporting and Data System Version 2 (PI-RADSv2) score before and after TRT were summarized. Results: After TRT, there was a significant increase in serum testosterone (516.5 ng/dl vs. 203.0 ng/dl), PSA (4.2 ng/ml vs. 3.3 ng/ml), and prostate volume (55.2 cm(3) vs. 39.4 cm(3)). In total, 2 patients had biopsy progression during the study period. The PI-RADSv2 scores before and after TRT were unchanged in 10/12 patients; none of these demonstrated biopsy progression on post-TRT. The PI-RADSv2 scores increased after TRT in 2/12 patients; both showed Gleason score upgrade on follow-up biopsy. Of these 2 patients, 1 patient underwent radical treatment due to clinical progression. The area under the curve for detecting biopsy progression calculated from PI-RADSv2 score after TRT was 0.90, which was better than that calculated from post-TRT PSA level (0.48). Conclusions: After TRT, mpMRI findings remained stable in patients without biopsy progression, whereas PI-RADSv2 score increase was identified in patients with Gleason score upgrade on follow-up biopsy. (C) 2016 Elsevier Inc. All rights reserved.
引用
收藏
页码:530.e9 / 530.e14
页数:6
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