METHODS: This retrospective analysis included 1207 peripheral and 232 non-peripheral zone prostate cancer (PCa) patients who underwent mpMRI before RP (2012-2015), with the outcome of interest being 5-year BCR. ADC was evaluated as a continuous variable and as categories: low (< 850 µm2/s), intermediate (850-1100 µm2/s), and high (> 1100 µm2/s). Kaplan-Meier curves with log-rank testing of BCR-free survival, multivariable Cox proportional hazard regression models were formed to estimate the risk of BCR.
RESULTS: Among the 1439 males with median age 63 (± 7) years, the median follow-up was 59 months, and 306 (25%) patients experienced BCR. Peripheral zone PCa patients with BCR had lower tumor ADC values than those without BCR (874 versus 1025 µm2/s, p < 0.001). Five-year BCR-free survival rates were 52.3%, 74.4%, and 87% for patients in the low, intermediate, and high ADC value categories, respectively (p < 0.0001). Lower ADC was associated with BCR, both as continuously coded variable (HR: 5.35; p < 0.001) and as ADC categories (intermediate versus high ADC-HR: 1.56, p = 0.017; low vs. high ADC-HR; 2.36, p < 0.001). In the non-peripheral zone PCa patients, no association between ADC and BCR was observed.
CONCLUSIONS: Tumor ADC values and categories were found to be predictive of the 5-year BCR risk after RP in patients with peripheral zone PCa and may serve as a prognostic biomarker.
方法:这项回顾性分析包括1207例周围区和232例非周围区前列腺癌(PCa)患者,这些患者在RP(2012-2015)之前接受了mpMRI,感兴趣的结果是5年BCR。ADC被评估为连续变量和类别:低(<850µm2/s),中间(850-1100µm2/s),和高(>1100µm2/s)。无BCR生存的对数秩检验的Kaplan-Meier曲线,建立多变量Cox比例风险回归模型来估计BCR的风险。
结果:在1439名男性中,中位年龄63(±7)岁,中位随访时间为59个月,306例(25%)患者出现BCR。有BCR的外周区PCa患者的肿瘤ADC值低于无BCR的患者(874对1025µm2/s,p<0.001)。5年无BCR生存率为52.3%,74.4%,87%的患者处于低位,中间,和高ADC值类别,分别(p<0.0001)。较低的ADC与BCR相关,作为连续编码变量(HR:5.35;p<0.001)和ADC类别(中等与高ADC-HR:1.56,p=0.017;低与高ADC-HR;2.36,p<0.001)。在非外周区PCa患者中,ADC和BCR之间没有相关性.
结论:发现肿瘤ADC值和类别可预测周围区PCa患者RP后5年BCR风险,并可作为预后生物标志物。