Evidence map›Paper›PMID 40185926›Full record

ArticleEuropean radiology2025

MRI-detected extranodal extension as a marker of prostate cancer aggressiveness.

Aline Araújo Naves, Gabriel de Lion Gouvea, Camila V B Machado, Leandro Machado Colli, Fernando Chahud, Rodolfo B Reis, Valdair F Muglia

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Article in European radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

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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

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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

1 citing paper in PubMed.

  1. Review
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Aline Araújo NavesDepartment of Imaging, Oncology and Hematology, Ribeirao Preto School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
Gabriel de Lion GouveaDepartment of Imaging, Oncology and Hematology, Ribeirao Preto School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
Camila V B MachadoDepartment of Imaging, Oncology and Hematology, Ribeirao Preto School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
Leandro Machado ColliDepartment of Imaging, Oncology and Hematology, Ribeirao Preto School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
Fernando ChahudDepartment of Pathology, Ribeirao Preto School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
Rodolfo B ReisDepartment of Surgery and Anatomy, Urology Division, Ribeirao Preto School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
Valdair F MugliaDepartment of Imaging, Oncology and Hematology, Ribeirao Preto School of Medicine, University of Sao Paulo, Sao Paulo, Brazil. fmuglia@fmrp.usp.br.ORCID http://orcid.org/0000-0002-4700-0599

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveExtranodal extension (ENE) is a histological marker of aggressiveness for various cancers. We evaluated if clinical ENE, detected by Magnetic Resonance Imaging, can also serve as a biological marker of Prostate Cancer (PCa) aggressiveness. MATERIALS AND

methodsThis retrospective, single-center study analyzed patients diagnosed with PCa and had MRI on a 3-T scanner from January 2013 to December 2017. After exclusions, 461 patients were included and divided into: Group 1, no lymph node involvement (LNI), Group 2 (LNI without ENE), and Group 3 (LNI and ENE). Two experienced radiologists assessed the MRI scans for primary lesion characteristics, LNI and ENE. Reproducibility assessment was calculated for ENE and PI-RADS. Clinical outcomes, including Overall Survival (OS), Specific Survival Rate (SSR), and Progression-Free Survival (PFS), were analyzed.

resultsGroup 1 included 410 patients, Group 2, 32 patients, and Group 3, 19 patients. The prevalence of ENE was 4.1%. Significant differences between groups were observed for age, PSA, dPSA, ISUP scores, clinical risk stratification, and staging (all p < 0.01). The Kappa coefficient for ENE was 0.75 (95% CI: 0.56-0.90), and 0.48 (0.14-1.0) for PI-RADS. Cox proportional hazards model showed PSA (HR: 1.009; 95% CI = 1.003-1.015, p < 0.01) and ENE (HR: 8.50; 1.76-40.98, p < 0.01) were associated with SSR, and both ENE (HR: 8.18; 2.34-28.58, p < 0.01) and LNI (HR: 5.99, 1.97-18.17, p < 0.01) were linked to poor PFS.

conclusionMRI-detected ENE, despite low prevalence, is a predictor of SSR and PFS in PCa. These findings support ENE as an independent prognostic marker. Further prospective, multi-institutional studies are required to validate these results. KEY POINTS: Question Pathological extranodal extension (pENE) has been described as a marker of worrisome prognosis in prostate cancer (PCa), but clinical ENE has not been evaluated as a marker of prognosis in PCa. Findings MRI-detected clinical ENE, had a low prevalence in our cohort (4.1%), but it was a predictor of specific survival rate and progression-free survival. Clinical relevance MRI-detected clinical ENE, a reproducible imaging feature, may serve as a non-invasive biomarker for aggressive prostate cancer. It correlates with poorer progression-free survival and specific survival rates, offering valuable prognostic insights for patient management.

Indexed as

Extranodal ExtensionMagnetic Resonance ImagingProstatic NeoplasmsAgedAged, 80 and overHumansLymphatic MetastasisMaleMiddle AgedReproducibility of ResultsRetrospective StudiesExtranodal extensionMagnetic resonance imagingPrognosisProstate cancer

Identifiers

PMID40185926

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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.