MP93-19 PROSTATE MRI PRIOR TO PROSTATECTOMY DOES NOT IMPACT SURGICAL OUTCOMES

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy VII1 Apr 2017MP93-19 PROSTATE MRI PRIOR TO PROSTATECTOMY DOES NOT IMPACT SURGICAL OUTCOMES Eric Kim, Joel Vetter, Michael Glamore, Seth Strope, Robert Grubb III, and Gerald Andriole Eric KimEric Kim More articles by this author , Joel VetterJoel Vetter More articles by this author , Michael GlamoreMichael Glamore More articles by this author , Seth StropeSeth Strope More articles by this author , Robert Grubb IIIRobert Grubb III More articles by this author , and Gerald AndrioleGerald Andriole More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2901AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Multiparametric magnetic resonance imaging (MRI) of the prostate has been increasingly utilized for both diagnosis and staging of prostate cancer (PCa). Studies have suggested that pre-prostatectomy MRI is predictive of extracapsular extension and lymph node involvement. However, the impact of this additional information on surgical outcomes has not been well defined. We examined our institutional experience of prostatectomy with or without preoperative MRI. METHODS We identified patients at our institution who received prostate MRI within 6 months of prostatectomy for PCa between January 2012 and December 2015 (n=491). Using propensity scoring analysis, patients who had received MRI prior to prostatectomy were matched 1:1 to patients who did not receive preoperative MRI (based on age, race, body-mass index, comorbidity, PSA, Gleason score, and surgeon performing prostatectomy). The final matched cohort included 192 patients with preoperative MRI and 192 patients without. Multivariate regression analysis was performed for operative time, estimated blood loss (EBL), perioperative complication, 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, or positive surgical margins. Operative time and EBL were significantly associated with preoperative PSA and surgeon performing prostatectomy (p<0.01). Comorbidity (Charlson comorbidity index >2) was the only predictor of 30-day complication (p<0.01). The only predictor of positive surgical margin was increasing biopsy Gleason score (OR 2.3, p=0.04). CONCLUSIONS Although prostate MRI has become increasingly utilized in the diagnosis and staging of PCa, preoperative MRI does not impact technical prostatectomy outcomes in our institutional experience. Our findings do not support the routine use of preoperative MRI for surgical planning in patients with clinically localized PCa. Effects of preoperative MRI on patient self-reported outcomes after prostatectomy will be examined in the future. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1244 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Eric Kim More articles by this author Joel Vetter More articles by this author Michael Glamore More articles by this author Seth Strope More articles by this author Robert Grubb III More articles by this author Gerald Andriole More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...