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Journal cover image

RARP in high-risk prostate cancer: use of multi-parametric MRI and nerve sparing techniques.

Publication ,  Journal Article
Wang, J-G; Huang, J; Chin, AI
Published in: Asian J Androl
2014

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.

Duke Scholars

Published In

Asian J Androl

DOI

EISSN

1745-7262

Publication Date

2014

Volume

16

Issue

5

Start / End Page

715 / 719

Location

China

Related Subject Headings

  • Treatment Outcome
  • Robotic Surgical Procedures
  • Retrospective Studies
  • Prostatic Neoplasms
  • Prostatectomy
  • Prostate
  • Peripheral Nerves
  • Organ Sparing Treatments
  • Obstetrics & Reproductive Medicine
  • Neoplasm Staging
 

Citation

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ICMJE
MLA
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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 J Androl, 16(5), 715–719. https://doi.org/10.4103/1008-682X.129942
Wang, Jin-Guo, Jiaoti Huang, and Arnold I. Chin. “RARP in high-risk prostate cancer: use of multi-parametric MRI and nerve sparing techniques.Asian J Androl 16, no. 5 (2014): 715–19. https://doi.org/10.4103/1008-682X.129942.
Wang J-G, 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, Jin-Guo, et al. “RARP in high-risk prostate cancer: use of multi-parametric MRI and nerve sparing techniques.Asian J Androl, vol. 16, no. 5, 2014, pp. 715–19. Pubmed, doi:10.4103/1008-682X.129942.
Wang J-G, 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):715–719.
Journal cover image

Published In

Asian J Androl

DOI

EISSN

1745-7262

Publication Date

2014

Volume

16

Issue

5

Start / End Page

715 / 719

Location

China

Related Subject Headings

  • Treatment Outcome
  • Robotic Surgical Procedures
  • Retrospective Studies
  • Prostatic Neoplasms
  • Prostatectomy
  • Prostate
  • Peripheral Nerves
  • Organ Sparing Treatments
  • Obstetrics & Reproductive Medicine
  • Neoplasm Staging