Preop MRI Benefits Some Prostate Cancer Patients

STOCKHOLM—Preoperative magnetic resonance imaging (MRI) improves surgical margins in patients with non-palpable prostate cancer (PCa), Norwegian researchers reported at the European Association of Urology 29th annual meeting.

Erik Rud, MD, of Oslo University Hospital, Aker, and colleagues randomly assigned 413 PCa patients to have or not have preoperative MRI scans prior to radical prostatectomy. Among patients with non-palpable (cT1) tumors, those who had preoperative MRI scans had a significant 46% decreased risk of positive surgical margins (PSM) compared with those who did not have the scans. These patients constituted the largest patient subgroup (54% of the overall cohort).

For the cohort overall, the risk of PSM was 17% lower for the MRI group, but this decrease was not statistically significant. The researchers observed a trend toward lower PSM rates in other patient subgroups, but this, too, was not statistically significant. Nevertheless, Dr. Rud noted that his group believes these declines are clinically significant.

The cohort had a mean age of 63 years. The overall prevalence of pT3 disease was 53%. In addition, 26%, 49%, and 25% of patients had low-, intermediate-, and high-risk disease based on D'Amico criteria. The investigators defined PSM as extension of tumor into the cut surface.

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