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Staging Accuracy of Multiparametric Magnetic Resonance Imaging in Caucasian and African American Men Undergoing Radical Prostatectomy.

接受根治性前列腺切除术的白种人和非裔美国男性多参数磁共振成像的分期准确性。

  • 影响因子:1.46
  • DOI:10.1097/JU.0000000000000774
  • 作者列表:"Falagario UG","Ratnani P","Lantz A","Jambor I","Dovey Z","Verma A","Treacy PJ","Sobotka S","Martini A","Bashorun H","Ashan M","Wagaskar VG","Lewis S","Cormio L","Carrieri G","Kyprianou N","Mohamed N","Tewari A
  • 发表时间:2020-07-01
Abstract

PURPOSE:We compared the performance of multiparametric magnetic resonance imaging for the prediction of extraprostatic extension in African American and Caucasian American men and evaluated racial disparities in pathological outcomes after radical prostatectomy. MATERIALS AND METHODS:We identified 975 patients who underwent radical prostatectomy with preoperative multiparametric magnetic resonance imaging between January 2013 and April 2019 at our institution. Multivariable logistic regression analysis was performed predicting pathological extraprostatic extension, high grade prostate cancer (final pathology GGG [Gleason Grade Group] 3 or greater) in the overall population and pathological upgrading (final pathology GGG 3 or greater) in patients with a diagnosis of GGG 1-2 prostate cancer. Adverse pathology was defined as pT3 and/or GGG 3 or greater. RESULTS:A total of 221 (23%) patients were African American. Preoperatively 594 (60.9%) were GGG 1-2 (low risk group) and 381 (39.1%) GGG 3 or greater (high risk group). In the low risk group rates of pathological extraprostatic extension (18% vs 12.8%, p=0.14), adverse pathology (18% vs 13.4%, p=0.2) or upgrading (9.4% vs 12.1%, p=0.4) were similar between races. Similarly, in the high risk group there was no difference in rates of pathological extraprostatic extension. On multivariable analysis multiparametric magnetic resonance imaging predicted the presence of extraprostatic extension (OR 1.80, 95% CI 1.29-2.50) and high grade prostate cancer (OR 1.82, 95% CI 1.25-2.67) on final pathology. Conversely, race did not predict the outcomes of interest (all values p >0.05). Multiparametric magnetic resonance imaging showed comparable sensitivity (22.22% vs 27.84%), specificity (89.2% vs 79.2%), positive predictive value (89.2% vs 83.4%) and negative predictive value (89.2% vs 83.4%) between African American and Caucasian America men, respectively. CONCLUSIONS:The accuracy of multiparametric magnetic resonance imaging in staging prostate cancer was similar in African American and Caucasian American patients and no difference was found between races in pathological outcomes after radical prostatectomy. These findings suggest that access to and use of advanced diagnostic tests may help mitigate prostate cancer racial disparities.

摘要

目的: 我们比较了多参数磁共振成像预测非裔美国人和高加索美国人前列腺外延伸的性能,并评估了根治性前列腺切除术后病理结果的种族差异。 材料和方法: 我们在2013年1月至2019年4月期间在我们的机构中确定了975例接受根治性前列腺切除术的术前多参数磁共振成像的患者。进行多变量logistic回归分析,预测总体人群中病理前列腺外延伸、高级别前列腺癌 (最终病理GGG [Gleason分级组] 3或更高) 和诊断为GGG 1-2前列腺癌患者的病理升级 (最终病理GGG 3或更高)。不良病理定义为pT3和/或GGG 3或更高。 结果: 共有221例 (23%) 患者为非裔美国人。术前594 (60.9%) 为GGG 1-2 (低风险组),381 (39.1%) 为GGG 3或更高 (高风险组)。在低风险组中,不同种族之间的病理前列腺外延伸率 (18% vs 12.8%,p = 0.14),不良病理 (18% vs 13.4%,p = 0.2) 或升级 (9.4% vs 12.1%,p = 0.4) 相似。类似地,在高风险组中,病理前列腺外延伸的比率没有差异。根据多变量分析,多参数磁共振成像预测最终病理存在前列腺外延伸 (OR 1.80,95% CI 1.29-2.50) 和高级别前列腺癌 (OR 1.82,95% CI 1.25-2.67)。相反,种族不能预测感兴趣的结果 (所有值p >0.05)。多参数磁共振成像显示,非裔美国人和高加索裔美国人男性之间的灵敏度 (22.22% vs 27.84%),特异性 (89.2% vs 79.2%),阳性预测值 (89.2% vs 83.4%) 和阴性预测值 (89.2% vs 83.4%) 相当。 结论: 在非裔美国人和白种人中,多参数磁共振成像对前列腺癌分期的准确性相似,在根治性前列腺切除术后的病理结果中,种族之间没有发现差异。这些发现表明,获得和使用先进的诊断测试可能有助于减轻前列腺癌种族差异。

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影响因子:2.56
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作者列表:["Renninger M","Fahmy O","Schubert T","Schmid MA","Hassan F","Stenzl A","Gakis G"]

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影响因子:1.46
发表时间:2020-02-01
来源期刊:The Journal of urology
DOI:10.1097/JU.0000000000000313
作者列表:["Alder R","Zetner D","Rosenberg J"]

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