Objective: To investigate the correlation between the PI-RADS score and the pathologic Gleason score in the final pathological grading and to detect risk factors associated with the outcomes. Materials and Methods: Data from January 2017 to September 2019 were reviewed. Inclusion criteria included patients who had undergone standard protocol prostate magnetic resonance imaging (MRI) in King Chulalongkorn Memorial Hospital and underwent radical prostatectomy during the period. Data collected were age, PI-RADS score, Gleason score (GS), prostate-specific antigen (PSA), prostate size, PSA density, lesion size, and extraprostatic extension (EPE) evident in MRI. Results: One hundred and eight patients were included. PI-RADS was significantly associated with GS (Chi-Square p = 0.039). The percentage of significant tumors found in PI-RADS 3, 4, 5 were 66%, 86% 90% respectively. Analysis of independent risk factors only found PI-RADS 5 to have a statistically significant association with GS ≥ 7 (OR6.67 (1.24-35.71) p = 0.03). The cut-off value of lesion size ≥ 15 vs < 15 and PI-RADS 4 had a higher odds ratio than other parameters (OR 3.89 (0.82-18.41) p = 0.09, OR 3.29 (0.79-13.86) p = 0.11 respectively). Conclusion: The PI-RADS scoring system was found to be highly associated with Gleason’s grading score. No association was found between any significant risk factor and significant prostate cancer. Lesion size could be used to combine with the PI-RADS scoring system in the detection of significant tumors. A high percentage of significant tumors were found with a PI-RADS 3 score and it may be worth taking a biopsy in the case of a PI-RADS 3 lesion.

Background: Radical nephrectomy is the treatment of choice for large renal cell carcinoma (RCC). Objectives: To describe the complications after radical nephrectomy for suspected or proven RCC and analyze the risk factors. Materials and methods:We retrospectively reviewed medical records from 110 patients who underwent radical nephrectomy for RCC in our institution between January 2007 and December 2013. The clinicopathological data of all patients were recorded and complications were graded using modified Clavien classification. Univariate and multivariate analysis was made of the predictive factors for complications. Results: Fifty postoperative complications occurred in 34 patients (31%) within 30 days, including 11% transfusion related complications. There were 22% minor complications (6% grade 1, 16% grade 2) and 9% major complication (5% grade 3, 2% grade 4, and 2% grade 5). The most common complications were transfusion-related, re-laparotomy because of bleeding, and prolong ileus. In univariate analysis, pathological T-stage (P = 0.001), American Society of Anesthesiologists (ASA) score (P = 0.007), tumor size (P = 0.01), and tumor diameter >4 cm (P = 0.03) were significant predicting factors. Major Charlson comorbidity index (CCI >2) was the only significant factor for major complications (P = 0.04). In multivariate analysis, ASA score was a significant independent predictor for overall complications (odds ratio 4.83, P = 0.01). Conclusions: ASA score was a significant predictive factor for overall postoperative complications. Comorbidities was also a predictor for major complications in radical nephrectomy. Preoperative risk stratification for complications should be considered during decision-making and for proper counseling of patients.

No abstract