MP62-06: Combined clinical characteristics and multiparametric MRI parameters for prediction of cribriform morphology in intermediate-risk prostate cancer patients
Introduction: To develop a risk model with combined clinical characteristics and multiparametric MRI (mpMRI) parameters for prediction of cribriform morphology in intermediate-risk prostate cancer (PCa) patients.
Methods: We retrospectively included 215 PCa patients received mpMRI examination, targeted biopsy (TB) combined with systematic biopsy (SB), radical prostatectomy and final Gleason group 2 or 3. Cribriform status was confirmed on both biopsy slices and whole-mount sections. Characteristics were stratified by cribriform status. Univariate and multivariate logistic regression analyses were performed for significant predictors, followed by cribriform-risk nomogram construction. Receiver operating characteristic (ROC) analysis was used for internal discrimination validation with corresponding area under the curve (AUC). Calibration curves were plotted and decision curve analysis were performed for clinical benefit exploration.
Results: Cribriform morphology was identified in 51.2% (110/215) patients. Sensitivities of TB, SB, TB+SB for detecting cribriform morphology were 28.2% (31/110), 22.7% (25/110) and 36.4% (40/110), respectively (Figure 1). Further, PSAD (P=0.003), PI-RADS score (P<0.001) and maximal biopsy Gleason score (P=0.004) were independent predictors for positive cribriform morphology. As shown in Figure 2, cribriform-risk nomogram was constructed with the three parameters and demonstrated considerable discrimination (AUC=0.887, sensitivity 79.2%, specificity 84.0%) and calibration (mean absolute error 0.021), harboring net benefits with threshold probabilities range from 0 to 0.88 (data not shown).
Conclusions: A cribriform-risk nomogram was developed and well predicted aggressive cribriform morphology in intermediate-risk prostate cancer patients. Source of
