Evidence map›Paper›PMID 33000302›Full record

ArticleEuropean radiology2021

Natural history of prostate cancer on active surveillance: stratification by MRI using the PRECISE recommendations in a UK cohort.

Francesco Giganti, Armando Stabile, Vasilis Stavrinides, Elizabeth Osinibi, Adam Retter, Clément Orczyk, Valeria Panebianco, Bruce J Trock, Alex Freeman, Aiman Haider and 5 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 1 pooled it
4.8field-weighted citation impact, top 4% of its field
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

34 citing papers in PubMed, 1 synthesis or guideline pooled it, 63 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 6 institutions in 3 countries.

Francesco GigantiDepartment of Radiology, University College London Hospital NHS Foundation Trust, London, UK. f.giganti@ucl.ac.uk.ORCID http://orcid.org/0000-0001-5218-6431
Armando StabileDivision of Surgery & Interventional Science, University College London, 3rd Floor, Charles Bell House, 43-45 Foley St., London, W1W 7TS, UK.
Vasilis StavrinidesDivision of Surgery & Interventional Science, University College London, 3rd Floor, Charles Bell House, 43-45 Foley St., London, W1W 7TS, UK.
Elizabeth OsinibiDivision of Surgery & Interventional Science, University College London, 3rd Floor, Charles Bell House, 43-45 Foley St., London, W1W 7TS, UK.
Adam RetterDepartment of Radiology, University College London Hospital NHS Foundation Trust, London, UK.
Clément OrczykDivision of Surgery & Interventional Science, University College London, 3rd Floor, Charles Bell House, 43-45 Foley St., London, W1W 7TS, UK.
Valeria PanebiancoDepartment of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy.
Bruce J TrockThe James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Alex FreemanDepartment of Pathology, University College London Hospital NHS Foundation Trust, London, UK.
Aiman HaiderDepartment of Pathology, University College London Hospital NHS Foundation Trust, London, UK.
Shonit PunwaniDepartment of Radiology, University College London Hospital NHS Foundation Trust, London, UK.
Clare AllenDepartment of Radiology, University College London Hospital NHS Foundation Trust, London, UK.
Alex KirkhamDepartment of Radiology, University College London Hospital NHS Foundation Trust, London, UK.
Mark EmbertonDivision of Surgery & Interventional Science, University College London, 3rd Floor, Charles Bell House, 43-45 Foley St., London, W1W 7TS, UK.
Caroline M MooreDivision of Surgery & Interventional Science, University College London, 3rd Floor, Charles Bell House, 43-45 Foley St., London, W1W 7TS, UK.
University College London Hospitals NHS Foundation Trust · GBJohns Hopkins University · USSapienza University of Rome · ITUniversity College Hospital · GBUniversity College London · GBVita-Salute San Raffaele University · IT

Funding

Medical Research Council MR/S005897/1University College London Graduate Research Scholarship
6 · The paper itself

Abstract

objectivesThe PRECISE recommendations for magnetic resonance imaging (MRI) in patients on active surveillance (AS) for prostate cancer (PCa) include repeated measurement of each lesion, and attribution of a PRECISE radiological progression score for the likelihood of clinically significant change over time. We aimed to compare the PRECISE score with clinical progression in patients who are managed using an MRI-led AS protocol.

methodsA total of 553 patients on AS for low- and intermediate-risk PCa (up to Gleason score 3 + 4) who had two or more MRI scans performed between December 2005 and January 2020 were included. Overall, 2161 scans were retrospectively re-reported by a dedicated radiologist to give a PI-RADS v2 score for each scan and assess the PRECISE score for each follow-up scan. Clinical progression was defined by histological progression to ≥ Gleason score 4 + 3 (Gleason Grade Group 3) and/or initiation of active treatment. Progression-free survival was assessed using Kaplan-Meier curves and log-rank test was used to assess differences between curves.

resultsOverall, 165/553 (30%) patients experienced the primary outcome of clinical progression (median follow-up, 74.5 months; interquartile ranges, 53-98). Of all patients, 313/553 (57%) did not show radiological progression on MRI (PRECISE 1-3), of which 296/313 (95%) had also no clinical progression. Of the remaining 240/553 patients (43%) with radiological progression on MRI (PRECISE 4-5), 146/240 (61%) experienced clinical progression (p < 0.0001). Patients with radiological progression on MRI (PRECISE 4-5) showed a trend to an increase in PSA density.

conclusionsPatients without radiological progression on MRI (PRECISE 1-3) during AS had a very low likelihood of clinical progression and many could avoid routine re-biopsy. KEY POINTS: • Patients without radiological progression on MRI (PRECISE 1-3) during AS had a very low likelihood of clinical progression and many could avoid routine re-biopsy. • Clinical progression was almost always detectable in patients with radiological progression on MRI (PRECISE 4-5) during AS. • Patients with radiological progression on MRI (PRECISE 4-5) during AS showed a trend to an increase in PSA density.

Indexed as

Magnetic Resonance ImagingProstatic NeoplasmsHumansImage-Guided BiopsyMaleNeoplasm GradingRetrospective StudiesUnited KingdomWatchful WaitingBiopsyMagnetic resonance imagingProstatic neoplasmsUrogenital neoplasms

Identifiers

PMID33000302
PMCPMC7880925
OpenAlexW3090168712

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.