Role of Changes in Magnetic Resonance Imaging or Clinical Stage in Evaluation of Disease Progression for Men with Prostate Cancer on Active Surveillance

被引:69
作者
Chesnut, Gregory T. [1 ]
Vertosick, Emily A. [2 ]
Benfante, Nicole [2 ]
Sjoberg, Daniel D. [2 ]
Fainberg, Jonathan [3 ]
Lee, Taehyoung [1 ]
Eastham, James [1 ]
Laudone, Vincent [1 ]
Scardino, Peter [1 ]
Touijer, Karim [1 ]
Vickers, Andrew [2 ]
Ehdaie, Behfar [1 ]
机构
[1] Mem Sloan Kettering Canc Ctr, Dept Surg, Urol Serv, New York, NY 10065 USA
[2] Mem Sloan Kettering Canc Ctr, Dept Epidemiol & Biostat, New York, NY 10065 USA
[3] New York Presbyterian Hosp, Dept Urol, Weill Cornell Med Ctr, New York, NY USA
基金
美国国家卫生研究院;
关键词
Prostate cancer; Active surveillance; Prostate imaging; Progression; Magnetic resonance imaging; BIOPSY; MRI;
D O I
10.1016/j.eururo.2019.12.009
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background: Active surveillance (AS) protocols rely on rectal examination, prostate-specific antigen, imaging, and biopsy to identify disease progression. Objective: To evaluate whether an AS regimen based on magnetic resonance imaging (MRI) or clinical stage changes can detect reclassification to grade group (GG) >= 2 disease compared with scheduled systematic biopsies. Design, setting, and participants: We identified a cohort of men initiated on AS between January 2013 and April 2016 at a single tertiary-care center. Patients completed confirmatory testing and prostate MRI prior to enrollment, then underwent laboratory and physical evaluation every 6 mo, MRI every 18 mo, and biopsy every 3 yr. Outcome measurements and statistical analysis: MRI results were evaluated using composite Likert/Prostate Imaging Reporting and Data System v2 scoring. MRI and clinical changes were assessed for association with disease progression. Univariable and multivariable regression models were used to predict upgrading on 3-yr biopsy. Results and limitations: At 3 yr, of 207 men, 66 (32%) had >= GG2 at biopsy: 55 (83%) with GG2, 10 (15%) with GG3, and one (1.5%) with GG4. Among patients with a 3-yr MRI score of >= 3, 41% had >= GG2 disease, compared with 15% with an MRI score of <3 (p = 0.0002). The MRI score increased in 48 men (23%), decreased in 27 (13%), and was unchanged in 132 (64%) men. Increases in MRI score were not associated with reclassification after adjusting for the 3-yr MRI score (p = 0.9). Biopsying only for an increased MRI score or clinical stage would avoid 681 biopsies per 1000 men, at the cost of missing >= GG2 disease in 169 patients. Conclusions: An AS strategy that uses MRI or clinical changes to trigger prostate biopsy avoids many biopsies but misses an unacceptable amount of clinically significant disease. Prostate biopsy for men on AS should be performed at scheduled intervals, regardless of stable imaging or examination findings. Patient summary: An active surveillance strategy for biopsy based only on increases in magnetic resonance imaging score or clinical stage will avoid many biopsies; however, it will miss many patients with clinically significant prostate cancer. Published by Elsevier B.V. on behalf of European Association of Urology.
引用
收藏
页码:501 / 507
页数:7
相关论文
共 22 条
[1]   Active Surveillance for Low-risk Prostate Cancer: The European Association of Urology Position in 2018 [J].
Briganti, Alberto ;
Fossati, Nicola ;
Catto, James W. F. ;
Cornford, Philip ;
Montorsi, Francesco ;
Mottet, Nicolas ;
Wirth, Manfred ;
Van Poppel, Hendrik .
EUROPEAN UROLOGY, 2018, 74 (03) :357-368
[2]   Trends in Management for Patients With Localized Prostate Cancer, 1990-2013 [J].
Cooperberg, Matthew R. ;
Carroll, Peter R. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2015, 314 (01) :80-82
[3]   Repeat multiparametric MRI in prostate cancer patients on active surveillance [J].
Eineluoto, Juho T. ;
Jarvinen, Petrus ;
Kenttamies, Anu ;
Kilpelainen, Tuomas P. ;
Vasarainen, Hanna ;
Sandeman, Kevin ;
Erickson, Andrew ;
Mirtti, Tuomas ;
Rannikko, Antti .
PLOS ONE, 2017, 12 (12)
[4]   A Contemporary Prostate Cancer Grading System: A Validated Alternative to the Gleason Score [J].
Epstein, Jonathan I. ;
Zelefsky, Michael J. ;
Sjoberg, Daniel D. ;
Nelson, Joel B. ;
Egevad, Lars ;
Magi-Galluzzi, Cristina ;
Vickers, Andrew J. ;
Parwani, Anil V. ;
Reuter, Victor E. ;
Fine, Samson W. ;
Eastham, James A. ;
Wiklund, Peter ;
Han, Misop ;
Reddy, Chandana A. ;
Ciezki, Jay P. ;
Nyberg, Tommy ;
Klein, Eric A. .
EUROPEAN UROLOGY, 2016, 69 (03) :428-435
[5]   Increasing Utilization of Multiparametric Magnetic Resonance Imaging in Prostate Cancer Active Surveillance [J].
Fam, Mina M. ;
Yabes, Jonathan G. ;
Macleod, Liam C. ;
Bandari, Jathin ;
Turner, Robert M., II ;
Lopa, Samia H. ;
Furlan, Alessandro ;
Filson, Christopher P. ;
Davies, Benjamin J. ;
Jacobs, Bruce L. .
UROLOGY, 2019, 130 :99-104
[6]   Magnetic Resonance Imaging-Transrectal Ultrasound Guided Fusion Biopsy to Detect Progression in Patients with Existing Lesions on Active Surveillance for Low and Intermediate Risk Prostate Cancer [J].
Frye, Thomas P. ;
George, Arvin K. ;
Kilchevsky, Amichai ;
Maruf, Mahir ;
Siddiqui, M. Minhaj ;
Kongnyuy, Michael ;
Muthigi, Akhil ;
Han, Hui ;
Parnes, Howard L. ;
Merino, Maria ;
Choyke, Peter L. ;
Turkbey, Baris ;
Wood, Brad ;
Pinto, Peter A. .
JOURNAL OF UROLOGY, 2017, 197 (03) :640-646
[7]   Can Clinically Significant Prostate Cancer Be Detected with Multiparametric Magnetic Resonance Imaging? A Systematic Review of the Literature [J].
Futterer, Jurgen J. ;
Briganti, Alberto ;
De Visschere, Pieter ;
Emberton, Mark ;
Giannarini, Gianluca ;
Kirkham, Alex ;
Taneja, Samir S. ;
Thoeny, Harriet ;
Villeirs, Geert ;
Villers, Arnauld .
EUROPEAN UROLOGY, 2015, 68 (06) :1045-1053
[8]   The natural history of prostate cancer on MRI: lessons from an active surveillance cohort [J].
Giganti, Francesco ;
Moore, Caroline M. ;
Punwani, Shonit ;
Allen, Clare ;
Emberton, Mark ;
Kirkham, Alex .
PROSTATE CANCER AND PROSTATIC DISEASES, 2018, 21 (04) :556-563
[9]   Multiparametric 3T MRI for the prediction of pathological downgrading after radical prostatectomy in patients with biopsy-proven Gleason score 3+4 prostate cancer [J].
Gondo, Tatsuo ;
Hricak, Hedvig ;
Sala, Evis ;
Zheng, Junting ;
Moskowitz, Chaya S. ;
Bernstein, Melanie ;
Eastham, James A. ;
Vargas, Hebert Alberto .
EUROPEAN RADIOLOGY, 2014, 24 (12) :3161-3170
[10]   Biomarkers in active surveillance [J].
Loeb, Stacy ;
Tosoian, Jeffrey J. .
TRANSLATIONAL ANDROLOGY AND UROLOGY, 2018, 7 (01) :155-159