MP82-20 PREOPERATIVE MULTIPARAMETRIC PROSTATE MRI IDENTIFIES PATIENTS AT RISK FOR LYMPH NODE INVOLVEMENT AT RADICAL PROSTATECTOMY (2015)

You have accessJournal of UrologyProstate Cancer: Advanced II1 Apr 2015MP82-20 PREOPERATIVE MULTIPARAMETRIC PROSTATE MRI IDENTIFIES PATIENTS AT RISK FOR LYMPH NODE INVOLVEMENT AT RADICAL PROSTATECTOMY Annerleim Walton Diaz, Steven Abboud, Arvin George, Raju Chelluri, Michele Fascelli, Richard Ho, Thomas P. Frye, Sandeep Sankineni, Maria J. Merino, Baris Turkbey, Bradford J. Wood, Peter L. Choyke, and Peter A. Pinto Annerleim Walton DiazAnnerleim Walton Diaz More articles by this author , Steven AbboudSteven Abboud More articles by this author , Arvin GeorgeArvin George More articles by this author , Raju ChelluriRaju Chelluri More articles by this author , Michele FascelliMichele Fascelli More articles by this author , Richard HoRichard Ho More articles by this author , Thomas P. FryeThomas P. Frye More articles by this author , Sandeep SankineniSandeep Sankineni More articles by this author , Maria J. MerinoMaria J. Merino More articles by this author , Baris TurkbeyBaris Turkbey More articles by this author , Bradford J. WoodBradford J. Wood More articles by this author , Peter L. ChoykePeter L. Choyke More articles by this author , and Peter A. PintoPeter A. Pinto More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.539AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Preoperative evaluation of lymph node status is an essential component of staging prior to definitive therapy for prostate cancer. Multiparametric prostate MRI provides high resolution imaging of intraprostatic anatomy in addition to encompassing the pelvic lymph nodes with the imaging template. Hereby we evaluate preoperative MRI characteristics associated with positive lymph nodes in patients undergoing robotic prostatectomy (RARP). METHODS We reviewed records for patients who underwent preoperative MRI prior to RARP between 2007 and 2014 at the National Institutes of Health. Clinical information, MRI and surgical pathology reports were reviewed. Univariate and multivariate analysis were performed to determine clinical factors and MRI parameters associated with lymph node positivity on surgical pathology. RESULTS 367 patients underwent MRI followed by RARP with whole mount histopathology at our institution. Mean age was 59.4 years, mean preoperative PSA 8.5 ng/ul. Five percent (19/367) of patients had positive lymph nodes on surgical pathology. Univariate analysis of preoperative variables found PSA (p=0.001), MRI suspicion score (P=0.001), number of prostatic lesions (p=0.01), suspicion of extracapsular extension (ECE) on MRI (p=0.001), and seminal vesicle invasion on MRI (SVI) (p=0.001) all correlated with positive lymph node findings. Multivariate logistic regression was preformed to control for confounding variables, finding PSA (OR 1.07 p=0.0066) and MRI variables of MR Spectroscopy positive (OR 4.18 p=0.0325), presence of ECE on MRI (OR 8.62 p=0.0006), and SVI on MRI (OR 11.74 p=0.017) to be predictive of positive lymph nodes on final pathology. CONCLUSIONS High risk features of ECE and SVI on MRI are independent predictors of lymph node involvement on final pathology and support the use of extended lymph node dissection in this cohort. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1045 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Annerleim Walton Diaz More articles by this author Steven Abboud More articles by this author Arvin George More articles by this author Raju Chelluri More articles by this author Michele Fascelli More articles by this author Richard Ho More articles by this author Thomas P. Frye More articles by this author Sandeep Sankineni More articles by this author Maria J. Merino More articles by this author Baris Turkbey More articles by this author Bradford J. Wood More articles by this author Peter L. Choyke More articles by this author Peter A. Pinto More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...