In this single institution prospective study, the authors analyze the outcomes from 2 sets of patients: 119 patients who had 3D mapping prior to surgery and 110 patients who did not. Among 119 patients with 3D-Cancer mapping, 39 patients had pT3 lesion which were successfully displayed during surgery with an attachment to the prostatic capsule. Of note, the authors made a point that nerve sparing was completed on the side opposite the index lesion; however, comment on NS on the side of the index lesion was not made.
While no significant difference was seen in cT2 patients, patients with cT3 disease who had pre-operative mapping had lower BCR (2-year recurrence-free survival rate 91% versus 69%, respectively, log-rank test p=0.0287).
Most surgeons are now considering the role of MRI pre-operatively in setting of high-risk prostate cancer, to help identify ECE and considerations of NS during the procedure. This study adds to that literature.
Limitations / Discussion / Future Directions:
1. The moderator made a very good point that tumor mapping may not be the reason. cT3 disease may have led to wide resection regardless of the mapping studies, thereby confounding the results.
2. Authors note that patients referred to the center who already had a biopsy, if randomized to the mapping study, underwent a separate mapping procedure.
Presented by: K. Kamoi
Co-Authors: Okihara K., Hongo F., Naitoh Y., Iwata A., Kanazawa M., Ushijima S., Ukimura O.
Institution: Kyoto Prefectural University of Medicine, Dept. of Urology, Kyoto, Japan
Written by: Thenappan Chandrasekar, Clinical Fellow, University of Toronto
at the #EAU17 -March 24-28, 2017- London, England