Peri-prostatic adipose tissue measurements using MRI predict prostate cancer aggressiveness in men undergoing radical prostatectomy.

Affiliation

Zhai T-(1), Hu L-(2), Ma W-(2)(3), Chen X(2), Luo M(1), Jin L(1), Zhou Z(1)(4), Liu X(1)(5), Kang Y(6), Kang Y-(6), Zhang J-(1), Liu H(1), Lu J-(7), Yao X-(8), Ye L(9)(10).
Author information:
(1)Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yan-Chang Rd., Jing-An District, Shanghai, 200072, China.
(2)Department of Urology, Karamay Central Hospital, No. 67, Middle Zhungaer Rd., Karamay, 834000, Xinjiang, China.
(3)Department of Urology, Tongxin People's Hospital, Tongxin, 751300, Ningxia, China.
(4)Department of Urology, First Clinical Medical College, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
(5)Department of Urology, Shanghai Putuo District People's Hospital, Tongji University School of Medicine, Shanghai, 200060, China.
(6)The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471000, Henan, China.
(7)Department of Urology, Karamay Central Hospital, No. 67, Middle Zhungaer Rd., Karamay, 834000, Xinjiang, China. [Email]
(8)Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yan-Chang Rd., Jing-An District, Shanghai, 200072, China. [Email]
(9)Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Middle Yan-Chang Rd., Jing-An District, Shanghai, 200072, China. [Email]
(10)Department of Urology, Karamay Central Hospital, No. 67, Middle Zhungaer Rd., Karamay, 834000, Xinjiang, China. [Email]

Abstract

OBJECTIVES: To evaluate the effect of peri-prostatic adipose tissue (PPAT) measurements using preoperative MRI on the prediction of prostate cancer (PCa) aggressiveness in men undergoing radical prostatectomy (RP). METHODS: We performed a retrospective study on 179 consecutive patients receiving RP from June 2016 to October 2018. Clinical characteristics were collected. PPAT measurements including peri-prostatic fat area (PPFA) and peri-prostatic fat area to prostate area (PA) ratio (PPFA/PA) were calculated by MRI. Multivariable logistic regression analysis was performed to identify independent predictors of PCa lymph node metastasis (LNM). The predictive performance was estimated through ROC curves. Nomograms were created based on the predictors. RESULTS: Pathologic Gleason score positively correlated with digital rectal examination (DRE), PSA, PPFA/PA, P504S, and Ki-67 (all P < 0.05). ROC curves revealed that high PPFA and high PPFA/PA were associated with LNM (both P < 0.05). Multivariate analysis revealed that high PPFA/PA, pathologic Gleason score, pT stage, and Ki-67 were independently predictive of LNM. The nomograms were created and the C-index was 0.945. CONCLUSIONS: PPFA/PA is an independent predictor for LNM along with Gleason score, pT stage, and Ki-67. PPFA/PA may help predict LNM in men undergoing RP, thus providing adjunctive information for therapeutic strategy and prognosis.