Objective: To determine the value of magnetic resonance imaging (MRI) in the surgical management of prostate cancer patients.
Patients and methods: 159 patients with prostate cancer underwent transrectal MRI before retropubic radical prostatectomy (RP). Patients operated despite a suspicion of extraprostatic extension on MRI had a modified non-nerve-sparing surgical technique. Postoperative histological findings were compared to MRI data.
Results: 34/159 patients (21.4%) had suspected extraprostatic extension in MRI. The pT3 rate on the RP specimen was significantly higher for patients with abnormal MRI than for patients with normal MRI (61% versus 39%, p = 0.02). Among pT3 patients, the positive surgical margin rate was significantly lower in the group with abnormal MRI than in the group with normal MRI (24% versus 51%, p = 0.035).
Conclusions: Among patients with stage pT3 on the RP specimen, those in whom extraprostatic extension was suspected on MRI were treated by a modified surgical technique resulting in a lower positive surgical margin rate.