Prognostic value of preoperative multiparametric magnetic resonance imaging ( MRI ) for predicting biochemical recurrence after radical prostatectomy

Objective To evaluate the suitability of preoperative multiparametric magnetic resonance imaging ( MRI ) positivity as a predictor of biochemical recurrence after radical prostatectomy ( RP ).Patients and Methods We reviewed the clinical records of patients who underwent either standard RP or laparoscopic RP between J anuary 2005 and D ecember 2009 at our institution. Patients who received radiotherapy or androgen deprivation therapy before surgery were excluded. A total of 314 patients met the study inclusion criteria. Cox proportional hazard regression models were used for analyses. In accordance with the criteria in the established guidelines, a radiologist scored the probability of the presence of prostate cancer using a five‐point scale of diagnostic confidence level. The highest confidence level of any pulse sequence was considered as the evaluation result.ResultsMRI positivity was significantly associated with a high clinical stage ( cT ≥ 2; P = 0.039), a high positive biopsy core rate (≥0.2; P < 0.001), a high biopsy G leason score ([ GS ] ≥8; P < 0.001) and a high pathological GS (≥8; P = 0.005). Univariate analysis and multivariate analysis showed that MRI positivity was a prognostic indicator in the analysis that included only preoperative variables and also in the analysis including preoperative and pathological variables.Conclusion Multiparametric MRI positivity can independently predict biochemical recurrence after RP .