Abstract：
OBJECTIVE: To assess the ability of tumor apparent diffusion coefficient (ADC) values obtained from multiparametric magnetic resonance imaging (mpMRI) to predict the risk of 5-year biochemical recurrence (BCR) after radical prostatectomy (RP).
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.
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.
摘要：
目的：评估从多参数磁共振成像（mpMRI）获得的肿瘤表观扩散系数（ADC）值预测前列腺癌根治术（RP）后5年生化复发（BCR）风险的能力。
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。
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。
