Endorectal coil magnetic resonance imaging and clinicopathologic findings in T1c adenocarcinoma of the prostate

Stage T1c prostate cancer has become the most commonly diagnosed clinical s tage of localized prostate cancer. Endorectal coil magnetic resonance imagi ng (erMRI) can be used in the staging of such patients The purpose of this study was to correlate the preoperative erMRI findings with the pathologic characteristics of thr surgical specimens. A database review of 355 radical prostatectomy specimens revealed 130 patients with T1c disease. Of these p atients, 124 were clinically staged with erMRI. Standard sensitivity analys is and multivariable analysis was then applied to determine the utility of erMRI in the staging of patients with T1c prostate cancer. The mean prostat e specific antigen (PSA) value was 8.3 (1.0-33.6), Most patients had Gleaso n score of 5 or 6 (51.6%) or 7 (33.1%), with fewer patients having Gleason scores between 2 and 4 (7.2%) or 8 and 10 (8.1%). The positive predictive v alue of erMRI for extracapsular disease was 38.7%. negative predictive valu e was 75.3%, and accuracy was 79%. Multivariable regression analysis demons trated that erMRI and preoperative PSA were predictive for seminal vesicle involvement. However, erMRI was not predictive in multivariable or univaria ble analysis for extracapsular extension or margin positivity. Previous inv estigators demonstrated the utility and independent significance of pre ope rative erMRI for a select subset of patients. However, it is not a useful s taging modality for patients with T1c cancer as a whole. Further stratifica tion of the T1c patients would be necessary to identify patients within thi s group who may benefit from staging with erMRI. (C) 2000 Elsevier Science inc. All rights reserved.