MP80-14 MRI PRIOR TO PROSTATECTOMY DOES NOT IMPROVE SURGICAL OUTCOMES

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy VII1 Apr 2016MP80-14 MRI PRIOR TO PROSTATECTOMY DOES NOT IMPROVE SURGICAL OUTCOMES Eric Kim, Niraj Badhiwala, Joel Vetter, Robert Grubb, and Gerald Andriole Eric KimEric Kim More articles by this author , Niraj BadhiwalaNiraj Badhiwala More articles by this author , Joel VetterJoel Vetter More articles by this author , Robert GrubbRobert Grubb More articles by this author , and Gerald AndrioleGerald Andriole More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2046AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Magnetic resonance imaging (MRI) of the prostate has been increasingly utilized in the diagnosis of prostate cancer (PCa). Multiple studies have demonstrated benefits in risk stratification of patients as well as biopsy outcomes with MRI. However, the added value of prostate MRI prior to surgical intervention is not well defined. We examined our institutional experience in order to evaluate for improvements in prostatectomy outcomes associated with preoperative MRI. METHODS We identified patients at our institution who underwent prostatectomy for PCa between January 2012 and June 2015 (n=465). Of these patients, 199 had received MRI prior to prostatectomy. Using propensity scoring analysis, patients who had received MRI prior to prostatectomy were matched 1:1 to patients who did not receive MRI, based on age, comorbidity, body-mass index (BMI), prostate-specific antigen (PSA), and biopsy Gleason score. The final matched cohort included 128 patients with preoperative MRI and 128 patients without. Multivariate logistic and linear regression analysis was performed on this cohort examining operative time, estimated blood loss (EBL), perioperative complication, lymph node yield, and positive surgical margin. RESULTS When controlling for all measured variables between the propensity matched cohorts, preoperative MRI was not predictive of operative time, EBL, complications, lymph node yield, or positive surgical margins. No measured variable was predictive of a perioperative complication in this cohort. Preoperative biopsy Gleason score 8 and 9 were predictive of lymph node yield (Estimate 3.2, p=0.02 and 4.8, p<0.01) on multivariate linear regression. Preoperative PSA was predictive of positive surgical margin (OR=1.06, p=0.03). The only predictive variable for EBL and operative time was surgeon. CONCLUSIONS Although prostate MRI has become increasingly utilized in the diagnosis of PCa, preoperative MRI does not improve technical prostatectomy outcomes in our institutional experience. At this time, for patients who are already diagnosed with PCa and planned to undergo prostatectomy, preoperative MRI should not be recommended. Future studies should examine the impact of preoperative MRI on patient self-reported outcomes of urinary continence and sexual function after prostatectomy. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1048 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Eric Kim More articles by this author Niraj Badhiwala More articles by this author Joel Vetter More articles by this author Robert Grubb More articles by this author Gerald Andriole More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...