Login to Access Video or Poster Abstract: MP93-19
Sources of Funding: None

Introduction

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.

Funding

None