Tumor contact length used as a biomarker to predict extracapsular extension, lymph node involvement, and biochemical recurrence.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e16588-e16588
Author(s):  
Públio Viana ◽  
Thiana Rodrigues ◽  
Davi alves martins Mota ◽  
Giuliano Guglielmetti ◽  
Diogo Assed Bastos ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
Magnetic Resonance ◽  
Radical Prostatectomy ◽  
Biochemical Recurrence ◽  
Specific Antigen ◽  
Contact Length ◽  
Imaging Biomarker ◽  
Exclusion Criterion

e16588 Background: Prostate cancer (PC) is the cancer most commonly diagnosed in men and the second leading cause of death. Multiparametric magnetic resonance imaging (mpMRI) is the benchmark imaging standard for local staging of PC. Patients with pathological extraprostatic tumor (pEPE) have a worse prognosis than those with confined organ disease with a higher risk of biochemical recurrence (BCR) after radical prostatectomy (RP). These factors, in addition to positive lymph nodes (PLN), are pivotal in the decision-making process regarding treatment. However, the subjective MRI analysis has low sensitivity in the detection of EPE and is plagued by the low interobserver agreement. Tumor contact length (TCL) is an objective parameter of mpMRI defined as the length of prostate cancer in contact with the prostate capsule, which may provide additional information about prostate cancer outcomes. We aimed to evaluate TCL as a predictor of pECE, PLN, and BCR in patients undergoing RP. Methods: In this Institutional Review Board approved single-institution prospective study, we update the follow-up of 148 patients and included 31 new patients, with prostate cancer who underwent prostate MRI before radical prostatectomy from March 2014 to november 2018. TCL was measured using T2-weighted magnetic resonance images.Postoperative prostate-specific antigen (PSA) values were obtained every 3 months in the first year, then biannually and annually thereafter. BCR was defined as PSA≥0.2ng/mL. The exclusion criterion was prior treatment. Results: The median follow-up was 44 months. 76/179 (42,4%) patients had pEPE, 12/179 (6,7%) had pLN, and 29/179 (16,2%) had BCR. TCL values were significantly higher in patients with pathological pECE ( 20,6 mm vs 9,9 mm, p < 0.001). Using a cut-off of 11,9 mm we found area under curve (AUC) of 0,71 to predict pathological ECE, with sensitivity 72,5% and specificity 67,5% . Using a cut-off of 16,5 mm we found AUC of 0,64 to predict BCR, with sensitivity 54,2% and specificity 67,8% and with a cut-off of 21,7 mm the AUC to predict PLN was 0,77, with sensitivity 66,7% and specificity 83,6%. Conclusions: We prospectively demonstrated in our population that TCL values were significantly higher in patients with pEPE , PLN and BCR. If validated, this imaging biomarker may facilitate and inform patient counseling and decision-making.

scholarly journals Dr. Answer AI for Prostate Cancer: Predicting Biochemical Recurrence Following Radical Prostatectomy

2021 ◽  
Vol 20 ◽  
pp. 153303382110246
Author(s):  
Jihwan Park ◽  
Mi Jung Rho ◽  
Hyong Woo Moon ◽  
Jaewon Kim ◽  
Chanjung Lee ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Random Forest ◽  
Radical Prostatectomy ◽  
Prediction Model ◽  
Biochemical Recurrence ◽  
Clinical Decision ◽  
Outcome Variable ◽  
Tertiary Hospitals ◽  
Input Variables

Objectives: To develop a model to predict biochemical recurrence (BCR) after radical prostatectomy (RP), using artificial intelligence (AI) techniques. Patients and Methods: This study collected data from 7,128 patients with prostate cancer (PCa) who received RP at 3 tertiary hospitals. After preprocessing, we used the data of 6,755 cases to generate the BCR prediction model. There were 16 input variables with BCR as the outcome variable. We used a random forest to develop the model. Several sampling techniques were used to address class imbalances. Results: We achieved good performance using a random forest with synthetic minority oversampling technique (SMOTE) using Tomek links, edited nearest neighbors (ENN), and random oversampling: accuracy = 96.59%, recall = 95.49%, precision = 97.66%, F1 score = 96.59%, and ROC AUC = 98.83%. Conclusion: We developed a BCR prediction model for RP. The Dr. Answer AI project, which was developed based on our BCR prediction model, helps physicians and patients to make treatment decisions in the clinical follow-up process as a clinical decision support system.

scholarly journals Pattern of failure in prostate cancer previously treated with radical prostatectomy and post-operative radiotherapy: a secondary analysis of two prospective studies using novel molecular imaging techniques

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lindsay S. Rowe ◽  
Stephanie Harmon ◽  
Adam Horn ◽  
Uma Shankavaram ◽  
Soumyajit Roy ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Pet Imaging ◽  
Biochemical Recurrence ◽  
Imaging Techniques ◽  
Specific Antigen ◽  
Definitive Treatment ◽  
Pattern Of Failure ◽  
Link Type ◽  
Psma Pet

Abstract Background Prostate Membrane Specific Antigen (PSMA) positron emission tomography (PET) and multiparametric MRI (mpMRI) have shown high accuracy in identifying recurrent lesions after definitive treatment in prostate cancer (PCa). In this study, we aimed to outline patterns of failure in a group of post-prostatectomy patients who received adjuvant or salvage radiation therapy (PORT) and subsequently experienced biochemical recurrence, using 18F-PSMA PET/CT and mpMRI. Methods PCa patients with biochemical failure post-prostatectomy, and no evident site of recurrence on conventional imaging, were enrolled on two prospective trials of first and second generation 18F-PSMA PET agents (18F-DCFBC and 18F-DCFPyL) in combination with MRI between October 2014 and December 2018. The primary aim of our study is to characterize these lesions with respect to their location relative to previous PORT field and received dose. Results A total of 34 participants underwent 18F-PSMA PET imaging for biochemical recurrence after radical prostatectomy and PORT, with 32/34 found to have 18F-PSMA avid lesions. On 18F-PSMA, 17/32 patients (53.1%) had metastatic disease, 8/32 (25.0%) patients had locoregional recurrences, and 7/32 (21.9%) had local failure in the prostate fossa. On further exploration, we noted 6/7 (86%) of prostate fossa recurrences were in-field and were encompassed by 100% isodose lines, receiving 64.8–72 Gy. One patient had marginal failure encompassed by the 49 Gy isodose. Conclusions 18F-PSMA PET imaging demonstrates promise in identifying occult PCa recurrence after PORT. Although distant recurrence was the predominant pattern of failure, in-field recurrence was noted in approximately 1/5th of patients. This should be considered in tailoring radiotherapy practice after prostatectomy. Trial registrationwww.clinicaltrials.gov, NCT02190279 and NCT03181867. Registered July 12, 2014, https://clinicaltrials.gov/ct2/show/NCT02190279 and June 8 2017, https://clinicaltrials.gov/ct2/show/NCT03181867.

Role of ultrasensitive prostate-specific antigen in the follow-up of prostate cancer after radical prostatectomy

2015 ◽  
Vol 33 (1) ◽  
pp. 16.e1-16.e7 ◽  
Author(s):  
Heikki Seikkula ◽  
Kari T. Syvänen ◽  
Samu Kurki ◽  
Tuomas Mirtti ◽  
Pekka Taimen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Prostate Specific Antigen ◽  
Specific Antigen

scholarly journals Consensus on Treatment and Follow-Up for Biochemical Recurrence in Castration-Sensitive Prostate Cancer: A Report From the First Global Prostate Cancer Consensus Conference for Developing Countries

2021 ◽  
pp. 538-544
Author(s):  
Fernando S. M. Monteiro ◽  
Fabio A. Schutz ◽  
Igor A. P. Morbeck ◽  
Diogo A. Bastos ◽  
Fernando V. de Padua ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Developing Countries ◽  
Biochemical Recurrence ◽  
Specific Antigen ◽  
Consensus Conference ◽  
Limited Resources ◽  
Response Options ◽  
Recommended Treatment ◽  
Clinical Scenarios

PURPOSE To present a summary of the treatment and follow-up recommendations for the biochemical recurrence in castration-sensitive prostate cancer (PCa) acquired through a questionnaire administered to 99 PCa experts from developing countries during the Prostate Cancer Consensus Conference for Developing Countries. METHODS A total of 27 questions were identified as related to this topic from more than 300 questions. The clinician's responses were tallied and presented in a percentage format. Topics included the use of imaging for staging biochemical recurrence, treatment recommendations for three different clinical scenarios, the field of radiation recommended, and follow-up. Each question had 5-7 relevant response options, including “abstain” and/or “unqualified to answer,” and investigated not only recommendations but also if a limitation in resources would change the recommendation. RESULTS For most questions, a clear majority (> 50%) of clinicians agreed on a recommended treatment for imaging, treatment scenarios, and follow-up, although only a few topics reached a consensus > 75%. Limited resources did affect several areas of treatment, although in many cases, they reinforced more stringent criteria for treatment such as prostate-specific antigen values > 0.2 ng/mL and STAMPEDE inclusion criteria as a basis for recommending treatment. CONCLUSION A majority of clinicians working in developing countries with limited resources use similar cutoff points and selection criteria to manage patients treated for biochemically recurrent castration-sensitive PCa.

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