Imaging technology can help predict cancer recurrence after surgery

This study examined the imaging technique multiparametric magnetic resonance imaging (mpMRI) as a predictor of disease recurrence after prostate surgery. Researchers concluded that the addition of mpMRI results improves the prediction of disease recurrence after surgery.

Prostate surgery is one of the recommended treatment options for localized (confined) prostate cancer. It has been estimated that up to 27% of men experience disease recurrence after surgery. Two-thirds of recurrences likely occur within 2 years after surgery. Identifying reliable predictors of disease recurrence is therefore very useful in the treatment decision-making.

Certain cancer markers help determine the risk of prostate cancer recurrence after treatment. These include tumor stage, PSA level (prostate specific antigen; a protein elevated in the blood in prostate cancer), and cancer tissue samples (high Gleason score indicates more aggressive cancer cells). Multiparametric magnetic resonance imaging (mpMRI) is a non-invasive method to provide a visual representation of the interior of the body. While mpMRI is increasingly used for prostate cancer diagnosis, its value in predicting recurrence is less well understood.

The aim of this study was to assess whether mpMRI can predict disease recurrence after prostate surgery.

The records of 370 men with prostate cancer treated with prostate surgery were analyzed. All men underwent mpMRI before surgery. The mpMRI scan measured the extent of cancer, prostate volume, and extension of cancer into neighboring tissue. An mpMRI suspicion score is calculated based on these results. Patients were followed for an average of 22.3 months.

10.5% of men experienced disease recurrence (based on blood tests) during the study period. The average time to recurrence was 14 months.

High PSA levels and high Gleason scores before surgery were significant predictors of recurrence. mpMRI results were also significantly associated with recurrence. 66% of patients with a high mpMRI suspicion score were recurrence-free at 3 years. This was significantly lower compared to patients with moderate mpMRI suspicion scores (86%). Cancer extending outside the prostate was also associated with poorer recurrence-free rates.

Gleason score, mpMRI suspicion score, and cancer extension outside the prostate were strong predictors of disease recurrence. Together, they showed a predictive accuracy of 84%. PSA levels before surgery were found to be the weakest predictor of recurrence.

Researchers concluded that the addition of mpMRI results improves the prediction of disease recurrence after prostate surgery.

Since the analysis is based on 39 cases of disease recurrence, larger studies are needed to confirm these findings.