The investigators want to evaluate if preoperative MRI improves the surgical results, especially in respect to surgical margins. The impact on the surgical procedure will be evaluated. In addition the investigators will examine the accuracy of tumor detection, localization and staging.
Background: During the last two decades, Magnetic Resonance Imaging (MRI) of the prostate has evolved to become a promising tool in preoperative evaluation of prostate cancer. Several studies have evaluated the radiological and histopathological correlation. However, the sensitivity and specificity in regard to staging have shown wide ranges and poor reproducibility. These discrepancies can be explained by difference in patient selection, MRI methods, and criteria used for diagnosis. More studies are therefore needed to evaluate the clinical impact of preoperative MRI in patients with prostate cancer. Aims of the study: To evaluate 1) detection rate of tumor 1-3 (tumor 1 = index tumor), size of tumor 1-3, possible extraprostatic extension and predict presence of Gleason grade 4 and 5 tumor, 2) the influence of preoperative MRI on the surgical decision process with respect to the operative procedure for removal of the gland and pelvic lymph node dissection, and 3) the impact of preoperative MRI on the rate of positive surgical margins and functional results. Material and method: A prospective study including 400 consecutive patients referred to robot assisted laparoscopic prostatectomy randomised to preoperative MRI (intervention group) and no MRI (control group). The prostatectomy specimens will be histopathologically examined, and TNM classification will be performed according to 2002 AJCC standard.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
400
Preoperative staging
Oslo University Hospital
Oslo, Norway
Surgical margins
The surgical margins are assessed by evaluating the pathological specimen
Time frame: 30 days
Surgical decision process
Evaluated using questionaire
Time frame: 30 days
Preoperative TNM classification
Based upon preoperative MRI
Time frame: 1-4 weeks
Detection of Gleason grade 4 and 5
Time frame: 30 days
Functional outcome
Evaluate the functional outcome in respect to erectile dysfunction.
Time frame: 1 year after prostatectomy
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