Imaging and Pathology Correlations for Different Risk Stratification Models for Intermediate-risk Prostate Cancer

Area of Science:

• Urology
• Oncology
• Radiology

Background:

• Intermediate-risk (IR) prostate cancer requires accurate risk stratification to predict outcomes.
• Existing models like Memorial Sloan Kettering Cancer (MSKCC) and Prostate Cancer Risk Stratification (ProCaRS) are used for risk assessment.

Purpose of the Study:

• To evaluate if sub-stratifying intermediate-risk prostate cancer using MSKCC or ProCaRS models predicts adverse imaging or pathologic features.
• To determine the correlation between risk stratification models and adverse findings in intermediate-risk prostate cancer patients.

Main Methods:

• A study of 56 consecutive intermediate-risk prostate cancer patients who underwent multi-parametric MRI (mpMRI) and radical prostatectomy (RP).
• Statistical analysis using 2-sample T-tests assuming unequal variance to correlate risk groups with adverse findings.
• Assessment of imaging (mpMRI) and pathologic features, including index lesion suspicion and maximum tumor diameter (MTD).

Main Results:

• On mpMRI, the MSKCC unfavorable group showed higher index lesion suspicion scores (p=0.044).
• The ProCaRS model identified a higher maximum tumor diameter (MTD) in its high-risk group (p=0.047).
• Pathologic MTD was significantly higher in unfavorable IR patients for both MSKCC (23.3 vs. 17.6 mm, p=0.005) and ProCaRS (26.6 vs. 19.3 mm, p=0.022) models.

Conclusions:

• Both MSKCC and ProCaRS risk stratification models correlate with higher maximum tumor diameter in unfavorable intermediate-risk prostate cancer patients.
• These findings suggest that these models may be valuable in predicting adverse pathologic features and potentially worse clinical outcomes.