研究者情報

キクチ　エイジ   KIKUCHI EIJI   菊地栄次    所属   医学部医学科 腎泌尿器外科学    職種   主任教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Prediction of extraprostatic extension by MRI tumor contact length: difference between anterior and posterior prostate cancer.
掲載誌名	正式名：Prostate cancer and prostatic diseases 略　 称：Prostate Cancer Prostatic Dis ISSNコード：1476560813657852
掲載区分	国外
巻・号・頁	22(4),539-545頁
著者・共著者	Matsumoto Kazuhiro, Akita Hirotaka, Narita Keiichi, Hashiguchi Akinori, Takamatsu Kimiharu, Takeda Toshikazu, Kosaka Takeo, Mizuno Ryuichi, Kikuchi Eiji, Oya Mototsugu, Jinzaki Masahiro
発行年月	2019/12
概要	BACKGROUND:Tumor contact length (TCL) is defined as the extent of contact between prostate cancer and the prostatic capsule, and its predictive value for microscopic extraprostatic extension (EPE) has been reported. However, the impact of the zonal origin (anterior or posterior tumor) of the tumor on the diagnosis of EPE is controversial.METHODS:We retrospectively analyzed the records of 233 consecutive patients who underwent preoperative MRI and radical prostatectomy. We designated their tumors as anterior or posterior, and evaluated the correlation between the TCL measured by MRI and microscopic EPE in the radical prostatectomy specimen. Then, we created the predicted probability curves for EPE versus TCL for anterior and posterior prostate cancer.RESULTS:There were 109 patients (47%) with an anterior tumor and 124 patients (53%) with a posterior tumor. Postoperative pathological analysis confirmed pT3 in 18 patients (17%) with an anterior tumor and in 53 patients (43%) with a posterior tumor. Multivariate analysis demonstrated that the zonal origin of the tumor was an independent predictive factor for EPE. We developed separate probability curves of EPE versus TCL for anterior and posterior prostate cancer, which revealed that anterior tumors were less likely to invade the extraprostatic tissues. Among patients whose TCL was 10-20 mm, 9/32 patients (28%) with an anterior tumor had EPE compared with 24/45 patients (53%) with a posterior tumor (p = 0.036). The decision curve of this EPE predictive model had high clinical efficacy.CONCLUSIONS:Our results indicate that anterior tumors have more favorable pathological characteristics than posterior tumors with the same TCL measured by MRI. We constructed two separate predicted probability curves for EPE after discriminating anterior and posterior tumors, which will be useful for decision making in clinical practice.
DOI	10.1038/s41391-019-0136-3
PMID	30814680