Real-life PI-RADS score and biochemical recurrence after local treatment of prostate cancer in Afro-Caribbean men.

BACKGROUND

The diagnostic accuracy of prostate cancer has been improved by the use of multiparametric magnetic resonance imaging (MRI). However, the role of the Prostate Imaging-Reporting and Data System (PI-RADS) score in combination with MRI in predicting issues after local prostate cancer treatment remains unclear. The aim of this study was to evaluate the PI-RADS score as a predictive factor for biochemical recurrence or progression (BCR) of prostate cancer.

METHODS

This retrospective monocentric study included 304 men who underwent targeted prostate biopsies plus standard biopsies after MRI between 2017 and 2020. All the included patients had a PI-RADS score of at least 3. Survival probabilities were estimated by the Kaplan-Meier method. The hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between individual characteristics and BCR or progression were estimated using the Cox proportional hazards regression model for univariate and multivariate analyses. All tests were two-sided, and P<0.05 was considered to indicate statistical significance. All analyses were performed using StatView software version 5.0 and MedCalc software version 17.5.

RESULTS

In total, 283 patients were included in our study. The median age at biopsy was 67.8 years, and the median follow-up was 4.9 years. The median time to BCR or progression after active surveillance (AS) was 4.7 years. A total of 22.3% of the patients experienced biochemical recurrence. No risk factors for biochemical recurrence according to the MRI PI-RADS score were significantly identified by univariate or multivariate analyses. Biochemical-free survival was 87% for the PI-RADS 5 group, 90% for the PI-RADS 4 and 80% for the PI-RADS 3 group at 3 years. There were no significant differences among these three groups in terms of BCR-free survival (P=0.4).

CONCLUSION

In the present study, MRI lesion description with PI-RADS or the usual risk group did not seem to be sufficient to predict biochemical recurrence after local prostate cancer treatment, especially in our particular population. Future studies could pair the PI-RADS with histologic data of the prostatic index lesion to predict recurrence.