MP67-07 CAN WE PREDICT THE SITE OF POSITIVE SURGICAL MARGINS (PSM) BASED ON THE SITE OF THE INDEX LESION AT MULTIPARAMETRIC MRI? A TOPOGRAPHIC SINGLE CENTER STUDY

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP67-07 CAN WE PREDICT THE SITE OF POSITIVE SURGICAL MARGINS (PSM) BASED ON THE SITE OF THE INDEX LESION AT MULTIPARAMETRIC MRI? A TOPOGRAPHIC SINGLE CENTER STUDY Francesco Pellegrino, Giorgio Gandaglia, Armando Stabile, Elio Mazzone, Giuseppe Rosiello, Gabriele Sorce, Luigi Nocera, Simone Scuderi, Francesco Barletta, Riccardo Leni, Mario De Angelis, Antony Pellegrino, Pietro Scilipoti, Paolo Zaurito, Emanuele Zaffuto, R. Jeffrey karnes, Morgan Roupret, Francesco Montorsi, and Alberto Briganti Francesco PellegrinoFrancesco Pellegrino More articles by this author , Giorgio GandagliaGiorgio Gandaglia More articles by this author , Armando StabileArmando Stabile More articles by this author , Elio MazzoneElio Mazzone More articles by this author , Giuseppe RosielloGiuseppe Rosiello More articles by this author , Gabriele SorceGabriele Sorce More articles by this author , Luigi NoceraLuigi Nocera More articles by this author , Simone ScuderiSimone Scuderi More articles by this author , Francesco BarlettaFrancesco Barletta More articles by this author , Riccardo LeniRiccardo Leni More articles by this author , Mario De AngelisMario De Angelis More articles by this author , Antony PellegrinoAntony Pellegrino More articles by this author , Pietro ScilipotiPietro Scilipoti More articles by this author , Paolo ZauritoPaolo Zaurito More articles by this author , Emanuele ZaffutoEmanuele Zaffuto More articles by this author , R. Jeffrey karnesR. Jeffrey karnes More articles by this author , Morgan RoupretMorgan Roupret More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Alberto BrigantiAlberto Briganti More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003330.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The impact of multiparametric MRI on surgical approach during radical prostatectomy (RP) and on oncological outcomes after surgery is still controversial. We aimed at performing a detailed topographic description of the site of PSM according to the topographic location of IL at MRI. METHODS: Overall, 111 PCa patients undergoing MRI-targeted biopsy and bilateral nerve sparing RP at our centre between 2016 and 2022. All patients had PSM at final pathology. All patients had a single visible suspicious IL at MRI (PIRADS ≥3). We evaluated the site of PSM based on the IL location at MRI. IL and PSM location were categorized using the 3 regions scheme (Right vs Left vs Bilateral). We graphically described the site of PSM based on the IL using the alluvial plot. We evaluated whether the IL was correlated with the location of PSM (right vs left) using Pearson’s chi-square test. RESULTS: PIRADS score was 3, 4, and 5 in 22 (20%), 44 (40%), and 48 (40%) patients, respectively. Median IL volume was 1.3 cc. Overall, 10 (9%), 42 (38%) and 59 (53%) ILs were bilateral, on the left and right hemigland, respectively. Clinically significant PCa (defined as a Gleason score ≥7) was found in 93 (84%) patients at biopsy. At final pathology, extra capsular extension was found in 58 (52%) patients. Overall, 13 (12%), 41 (37%), and 57 (51%) patients had bilateral, left, and right PSM, respectively. The topographic distribution of the site of PSM according to the topographic location of the ROI is reported in Figure 1. The majority of PSMs were ipsilateral to the IL location. For instance, among the 59 patients with IL in the right emigland, 93% (n=55) had ipsilateral PSM, 3% (n=2) had contralateral PSM and 3% (n=2) had bilateral PSM. After excluding bilateral PSM, IL location was strongly associated with the site of PSM (p<0.001). CONCLUSIONS: Our analyses demonstrated that the majority of PSM are located on the same side of the MRI-visible lesion. A conservative nerve sparing RP approach could thus be safely considered to be performed on the contralateral side of IL at mpMRI. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e945 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Francesco Pellegrino More articles by this author Giorgio Gandaglia More articles by this author Armando Stabile More articles by this author Elio Mazzone More articles by this author Giuseppe Rosiello More articles by this author Gabriele Sorce More articles by this author Luigi Nocera More articles by this author Simone Scuderi More articles by this author Francesco Barletta More articles by this author Riccardo Leni More articles by this author Mario De Angelis More articles by this author Antony Pellegrino More articles by this author Pietro Scilipoti More articles by this author Paolo Zaurito More articles by this author Emanuele Zaffuto More articles by this author R. Jeffrey karnes More articles by this author Morgan Roupret More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Expand All Advertisement PDF downloadLoading ...