Journal article
External Validation of a Multiparametric Magnetic Resonance Imaging-based Nomogram for the Prediction of Extracapsular Extension and Seminal Vesicle Invasion in Prostate Cancer Patients Undergoing Radical Prostatectomy.
- Diamand R Urology Department, Hôpital Erasme, University Clinics of Brussels, Université Libre de Bruxelles, Brussels, Belgium. Electronic address: romain.diamand@erasme.ulb.ac.be.
- Ploussard G Urology Department, La Croix du Sud Hospital, Quint Fonsegrives, France.
- Roumiguié M Urology Department, CHU Toulouse, Toulouse, France.
- Oderda M Urology Department, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy.
- Benamran D Urology Department, Hôpitaux Universitaires de Genève, Geneva, Switzerland.
- Fiard G Urology Department, CHU de Grenoble, Grenoble, France; Grenoble Alpes University, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France.
- Quackels T Urology Department, Hôpital Erasme, University Clinics of Brussels, Université Libre de Bruxelles, Brussels, Belgium.
- Assenmacher G Urology Department, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium.
- Simone G Urology Department, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy.
- Van Damme J Urology Department, University Clinics Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
- Malavaud B Urology Department, Institut Universitaire du Cancer Toulouse-Oncopole, Toulouse, France.
- Iselin C Urology Department, Hôpitaux Universitaires de Genève, Geneva, Switzerland.
- Descotes JL Urology Department, CHU de Grenoble, Grenoble, France; Grenoble Alpes University, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France.
- Roche JB Urology Department, Clinique Saint-Augustin, Bordeaux, France.
- Peltier A Urology Department, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium.
- Roumeguère T Urology Department, Hôpital Erasme, University Clinics of Brussels, Université Libre de Bruxelles, Brussels, Belgium; Urology Department, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium.
- Albisinni S Urology Department, Hôpital Erasme, University Clinics of Brussels, Université Libre de Bruxelles, Brussels, Belgium.
- 2020-10-07
Published in:
- European urology. - 2020
English
The nomogram reported by Gandaglia et al (The key combined value of multiparametric magnetic resonance imaging, and magnetic resonance imaging-targeted and concomitant systematic biopsies for the prediction of adverse pathological features in prostate cancer patients undergoing radical prostatectomy. Eur Urol 2020;77:733-41) predicting extracapsular extension (ECE) or seminal vesicle invasion (SVI) has been developed using multiparametric magnetic resonance imaging (MRI) parameters and MRI-targeted biopsy. We aimed to validate this nomogram externally by analyzing 566 patients harboring prostate cancer diagnosed on MRI-targeted biopsy followed by radical prostatectomy. At final pathology, 37% and 12% patients had ECE and SVI, respectively. Performance of the nomogram, in comparison with the Memorial Sloan Kettering Cancer Center (MSKCC) model and Partin tables, was evaluated using discrimination, calibration, and decision curve analysis. Regarding ECE prediction, the nomogram showed higher discrimination (71.8% vs 69.8%, p = 0.3 and 71.8% vs 61.3%, p < 0.001), and similar miscalibration and net benefit for probability threshold above 30% when compared with MSKCC model and Partin tables, respectively. Performance of the nomogram with regard to SVI was comparable in terms of discrimination (68.5% vs 70.4% vs 67.8%, p ≥ 0.6), presenting a slight overestimation on calibration plots and a net benefit for probability threshold above 7.5%. This is the first multicentric study that externally validates a nomogram predicting ECE and SVI in patients diagnosed with MRI-targeted biopsy. Its performance was less optimistic than expected, and implementation of MRI in this setting was not associated with a clear improvement in patient selection and clinical usefulness when compared with available models. We proposed an updated version of the nomogram predicting ECE using the recalibration method, which leads to an improvement in its performance and needs to be validated in another external set. PATIENT SUMMARY: We validate a prediction tool based on multiparametric magnetic resonance imaging (MRI) parameters and MRI-targeted biopsy predicting extracapsular extension and seminal vesicle invasion at radical prostatectomy. An improvement of patient selection was not clearly demonstrated when compared with available models based on clinical parameters, and implementation of MRI in this setting still needs to be clarified.
- Language
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- English
- Open access status
- closed
- Identifiers
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- DOI 10.1016/j.eururo.2020.09.037
- PMID 33023770
- Persistent URL
- https://sonar.ch/global/documents/169724
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