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以磁共振成像为主导的前列腺癌风险适应的积极监测:来自大型队列研究的最新结果

Cameron Englman¹, Busola Adebusoye², Davide Maffei³

¹Division of Surgery & Interventional Science, University College London, London, UK; Department of Radiology, University College London Hospitals NHS Foundation Trust, London, UK.

European urology

|May 28, 2025

概括

以磁共振成像 (MRI) 为主导的前列腺癌主动监测 (AS) 有效地监测患者. 基线MRI可见度和格里森模式4预测进展,指导治疗决策以获得更好的结果.

科学领域:

在瘤学瘤学.
放射学放射学是一门学科.
泌尿器科泌尿器科泌尿器科泌尿器科

背景情况:

前列腺癌的积极监测 (AS) 依赖于前列腺特异性抗原 (PSA) 和MRI监测.
只有在PSA密度或MRI变化表明时,才能进行活检.

研究的目的:

为了评估MRI引导的AS在前列腺癌管理中的有效性.
确定AS期间疾病进展的预测因素.

主要方法:

分析了一组1150名患有低风险前列腺癌的患者 (格里森得分≤3 + 4,PSA<20 ng/ml) 在2000-2023年间的AS.
患者进行了至少两次MRI扫描;无事件生存期 (EFS) 被定义为组织学升级 (GS ≥4 + 3) 或治疗开始.
风险分层是基于基线MRI可见性和格里森模式4的基准,并使用卡普兰-梅尔曲线进行比较.

主要成果:

在5年后,EFS率有所不同:非可见GS3+3的91%,MRI可见GS3+3的71%,非可见GS3+4的70%和MRI可见GS3+4的44%.
67名患者 (6%) 的组织学升级至GS ≥4 + 3发生.
转移的进展很罕见,只发生在错过推的随访核磁共振成像或活检的患者中.

结论:

核磁共振成像可见性和基线Gleason模式4的存在是核磁共振成像导致AS期间进展的显著预测因素.
这些因素与初级格里森模式4的进展以及治疗的需要有关.

关键词:

积极监视活动的监视活动.前列腺癌是什么意思前列腺癌是什么意思前列腺磁共振成像 - 前列腺磁共振成像

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