Show simple item record

dc.contributor.authorJäderling, Fredrik
dc.contributor.authorAkre, Olof
dc.contributor.authorAly, Markus
dc.contributor.authorBjörklund, Johan
dc.contributor.authorOlsson, Mats
dc.contributor.authorAdding, Christofer
dc.contributor.authorÖberg, Michael
dc.contributor.authorBlomqvist, Lennart
dc.contributor.authorNyberg, Tommy
dc.contributor.authorWiklund, Peter
dc.contributor.authorCarlsson, Stefan
dc.date.accessioned2018-12-22T00:30:50Z
dc.date.available2018-12-22T00:30:50Z
dc.date.issued2019-09
dc.identifier.issn1365-7852
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/287380
dc.description.abstractBACKGROUND: It is unclear whether preoperative staging using Magnetic Resonance Imaging (MRI) reduces the risk of positive margins in prostate cancer. We aimed to assess the effect on surgical margins and degree of nerve sparing of a pelvic MRI presented at a preoperative MRI conference. METHODS: Single institution, observational cohort study including 1037 men that underwent robot assisted radical prostatectomy between October 2013 and June 2015. Of these, 557 underwent a preoperative MRI combined with a preoperative MRI conference and 410 did not. With whole-mount prostate specimen histopathology as gold standard we assessed the ability of MRI in finding the index tumor and the sensitivity and specificity for extra prostatic extension. We calculated relative risks for positive surgical margins and non-nerve sparing procedure, adjusting for preoperative risk factors using stabilized inverse-probability weighting. RESULTS: MRI detected the index tumor in 80% of the cases. Non-organ confined disease (pT3) at histology was present in the MRI and the non-MRI group in 42% and 24%, respectively. Rate of positive surgical margins comparing the MRI and non-MRI groups was 26.7% and 33.7%, respectively, relative risk 0.79 [95% CI 0.65-0.96], weighted relative risk (wRR) 0.69 [95% CI 0.55-0.86]. The wRR of extensive positive surgical margins was 0.45 [95% CI 0.31-0.67]. Undergoing MRI was also associated with an increased risk of being operated with a non-nerve sparing technique (wRR, 1.84 [95% CI 1.11-3.03]). CONCLUSIONS: Our study suggests that preoperative prostate MRI in combination with a preoperative MRI conference affects the degree of nerve-sparing surgery and reduces positive surgical margins.
dc.description.sponsorshipThe regional agreement on medical training and clinical research (ALF) between the Stockholm county council and Karolinska Insititutet
dc.format.mediumPrint-Electronic
dc.languageeng
dc.publisherSpringer Science and Business Media LLC
dc.subjectProstate
dc.subjectHumans
dc.subjectProstatic Neoplasms
dc.subjectMagnetic Resonance Imaging
dc.subjectBiopsy
dc.subjectNeoplasm Staging
dc.subjectProstatectomy
dc.subjectRisk Factors
dc.subjectSensitivity and Specificity
dc.subjectRetrospective Studies
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectMale
dc.subjectPreoperative Period
dc.subjectRobotic Surgical Procedures
dc.subjectMargins of Excision
dc.titlePreoperative staging using magnetic resonance imaging and risk of positive surgical margins after prostate-cancer surgery.
dc.typeArticle
prism.endingPage398
prism.issueIdentifier3
prism.publicationDate2019
prism.publicationNameProstate Cancer Prostatic Dis
prism.startingPage391
prism.volume22
dc.identifier.doi10.17863/CAM.34684
dcterms.dateAccepted2018-11-03
rioxxterms.versionofrecord10.1038/s41391-018-0116-z
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2019-09
dc.contributor.orcidJäderling, Fredrik [0000-0002-9042-7328]
dc.contributor.orcidNyberg, Tommy [0000-0002-9436-0626]
dc.identifier.eissn1476-5608
rioxxterms.typeJournal Article/Review
cam.issuedOnline2018-11-30
rioxxterms.freetoread.startdate2019-11-30


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record