Evidence map›Paper›PMID 31249386›Full record

ArticleProstate cancer and prostatic diseases2020

Confirmatory multiparametric magnetic resonance imaging at recruitment confers prolonged stay in active surveillance and decreases the rate of upgrading at follow-up.

Stefano Luzzago, Michele Catellani, Ettore Di Trapani, Gabriele Cozzi, Francesco A Mistretta, Roberto Bianchi, Paola Pricolo, Andrea Conti, Eleonora Ancona, Nicolò Piacentini and 8 more

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Article in Prostate cancer and prostatic diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors.

Stefano LuzzagoDepartment of Urology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, Milan, Italy. stefanoluzzago@gmail.com.
Michele CatellaniDepartment of Urology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, Milan, Italy.
Ettore Di TrapaniDepartment of Urology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, Milan, Italy.
Gabriele CozziDepartment of Urology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, Milan, Italy.ORCID http://orcid.org/0000-0001-6386-7013
Francesco A MistrettaDepartment of Urology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, Milan, Italy.
Roberto BianchiDepartment of Urology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, Milan, Italy.
Paola PricoloDepartment of Radiology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, Milan, Italy.
Andrea ContiDepartment of Urology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, Milan, Italy.
Eleonora AnconaUniversità degli Studi di Milano, Milan, Italy.
Nicolò PiacentiniDepartment of Urology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, Milan, Italy.
Sarah AlessiDepartment of Radiology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, Milan, Italy.
Giuseppe RenneDepartment of Pathology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, Milan, Italy.
Matteo FerroDepartment of Urology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, Milan, Italy.
Deliu-Victor MateiDepartment of Urology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, Milan, Italy.
Gennaro MusiDepartment of Urology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, Milan, Italy.
Barbara Alicja Jereczek-FossaUniversità degli Studi di Milano, Department of Oncology and Hematology-Oncology, Milan, Italy.
Giuseppe PetraliaDepartment of Radiology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, Milan, Italy.
Ottavio de CobelliDepartment of Urology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo understand the value of multiparametric magnetic resonance imaging (mpMRI) and targeted biopsies at recruitment on active surveillance (AS) outcomes. MATERIALS AND

methodsThis retrospective single-center study enrolled two cohorts of 206 and 310 patients in AS. The latter group was submitted to mpMRI and targeted biopsies at recruitment. Kaplan-meier curves quantified progression-free survival (PFS) and Bioptic-PFS (B-PFS: no upgrading or >3 positive cores) in the two cohorts. Cox-regression analyses tested independent predictors of PFS and B-PFS. In patients submitted to radical prostatectomy (RP) after AS, significant cancer (csPCa) was defined as: GS ≥ 4 + 3 and/or pT ≥ 3a and/or pN+ . Logistic-regression analyses predicted csPCa at RP. RESULTS AND LIMITATIONS: Median time follow-up and median time of persistence in AS were 46 (24-70) and 36 (23-58) months, respectively. Patients submitted to mpMRI at AS begin, showed greater PFS at 1- (98% vs. 91%), 3- (80% vs. 57%), and 5-years (70% vs. 35%) follow-up, respectively (all p < 0.01). At Cox-regression analysis only confirmatory mpMRI± targeted biopsy (HR: 0.3; 95% CI 0.2-0.5; p < 0.01) at AS begin was an independent predictor of PFS. Globally, 50 (16%) vs. 128 (62%) and 26 (8.5%) vs. 64 (31%) [all p < 0.01] men in the two groups experienced any-cause and bioptic AS discontinuation, respectively. Patients submitted to confirmatory mpMRI experienced greater 1-(98% vs. 93%), 3-(90% vs. 75%), and 5-years (83% vs. 56%) B-PFS, respectively (all p < 0.01). At Cox-regression analysis, mpMRI±-targeted biopsy at AS begin was associated with B-PFS (HR: 0.3; 95% CI 0.2-0.6; p < 0.01). No differences were recorded in csPCa rates between the two groups (22% vs. 28%; p = 0.47). Limitations of the study are the single-center retrospective nature and the absence of long-term follow-up.

conclusionsConfirmatory mpMRI±-targeted biopsies are associated with higher PFS and B-PFS during AS. However, a non-negligible percentage of patients experience csPCa after switching to active treatment.

Indexed as

Multiparametric Magnetic Resonance ImagingAdultAgedDisease ProgressionFollow-Up StudiesHumansImage-Guided BiopsyKaplan-Meier EstimateMaleMass ScreeningMiddle AgedPrognosisProportional Hazards ModelsProstatic NeoplasmsWatchful WaitingYoung Adult

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.