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RARP in high-risk prostate cancer: use of multi-parametric MRI and nerve sparing techniques.
Asian J Androl. 2014 Sep-Oct; 16(5):715-9.AJ

Abstract

To examine the outcomes of patients with high-risk prostate cancer (PCa) treated by robot-assisted radical prostatectomy (RARP) and evaluate the value of multi-parametric magnetic resonance imaging (MRI) in estimating tumor stage, extracapsular extension, and grade, and the application of nerve sparing (NS) techniques. Patient demographics, preoperative imaging, surgical parameters, pathological features, functional and recurrence outcomes were collected retrospectively in patients with high-risk PCa who underwent RARP between December 2009 and October 2013. Pathological whole mount slides to assess NS were compared with potency, recovery of continence, and surgical margins (SM). Forty-four cases of high-risk PCa were identified with a median followup of 24 months and positive surgical margins (PSM) rate of 14%. Continence returned in 86%, with potency rate of 58%. Of the 25 cases with a preoperative multi-parametric MRI, MRI improved clinical staging from 28% to 88%, respectively. Following risk stratification of NS by microscopic analysis of whole mount pathology, patients with Group A (bilateral NS), Group B (unilateral NS), Group C (partial NS), and Group D (non-NS) had 100%, 92%, 91%, and 50% continence rates, and 100%, 80%, 45%, and 0% potency rates, respectively, with an inverse correlation to PSM. RARP in men with high-risk PCa can achieve favorable oncologic and functional outcomes. Preoperative MRI may localize high-grade tumors and improve clinical staging. Extent of NS is influenced by clinical staging and may balance potency and continence with PSMs.

Authors+Show Affiliations

No affiliation info availableNo affiliation info availableDepartment of Urology, Institute of Urologic Oncology, Broad Stem Cell Research Center, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24969055

Citation

Wang, Jin-Guo, et al. "RARP in High-risk Prostate Cancer: Use of Multi-parametric MRI and Nerve Sparing Techniques." Asian Journal of Andrology, vol. 16, no. 5, 2014, pp. 715-9.
Wang JG, Huang J, Chin AI. RARP in high-risk prostate cancer: use of multi-parametric MRI and nerve sparing techniques. Asian J Androl. 2014;16(5):715-9.
Wang, J. G., Huang, J., & Chin, A. I. (2014). RARP in high-risk prostate cancer: use of multi-parametric MRI and nerve sparing techniques. Asian Journal of Andrology, 16(5), 715-9. https://doi.org/10.4103/1008-682X.129942
Wang JG, Huang J, Chin AI. RARP in High-risk Prostate Cancer: Use of Multi-parametric MRI and Nerve Sparing Techniques. Asian J Androl. 2014 Sep-Oct;16(5):715-9. PubMed PMID: 24969055.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - RARP in high-risk prostate cancer: use of multi-parametric MRI and nerve sparing techniques. AU - Wang,Jin-Guo, AU - Huang,Jiaoti, AU - Chin,Arnold I, PY - 2014/6/28/entrez PY - 2014/6/28/pubmed PY - 2015/7/1/medline SP - 715 EP - 9 JF - Asian journal of andrology JO - Asian J. Androl. VL - 16 IS - 5 N2 - To examine the outcomes of patients with high-risk prostate cancer (PCa) treated by robot-assisted radical prostatectomy (RARP) and evaluate the value of multi-parametric magnetic resonance imaging (MRI) in estimating tumor stage, extracapsular extension, and grade, and the application of nerve sparing (NS) techniques. Patient demographics, preoperative imaging, surgical parameters, pathological features, functional and recurrence outcomes were collected retrospectively in patients with high-risk PCa who underwent RARP between December 2009 and October 2013. Pathological whole mount slides to assess NS were compared with potency, recovery of continence, and surgical margins (SM). Forty-four cases of high-risk PCa were identified with a median followup of 24 months and positive surgical margins (PSM) rate of 14%. Continence returned in 86%, with potency rate of 58%. Of the 25 cases with a preoperative multi-parametric MRI, MRI improved clinical staging from 28% to 88%, respectively. Following risk stratification of NS by microscopic analysis of whole mount pathology, patients with Group A (bilateral NS), Group B (unilateral NS), Group C (partial NS), and Group D (non-NS) had 100%, 92%, 91%, and 50% continence rates, and 100%, 80%, 45%, and 0% potency rates, respectively, with an inverse correlation to PSM. RARP in men with high-risk PCa can achieve favorable oncologic and functional outcomes. Preoperative MRI may localize high-grade tumors and improve clinical staging. Extent of NS is influenced by clinical staging and may balance potency and continence with PSMs. SN - 1745-7262 UR - https://www.unboundmedicine.com/medline/citation/24969055/RARP_in_high_risk_prostate_cancer:_use_of_multi_parametric_MRI_and_nerve_sparing_techniques_ L2 - http://www.ajandrology.com/article.asp?issn=1008-682X;year=2014;volume=16;issue=5;spage=715;epage=719;aulast=Wang DB - PRIME DP - Unbound Medicine ER -