MRI DISPLAYS THE PROSTATIC CANCER ANATOMY AND IMPROVES THE BUNDLES MANAGEMENT BEFORE ROBOT ASSISTED RADICAL PROSTATECTOMY

To evaluate the impact of multiparametric magnetic resonance imaging (mpMRI) to guide the nerve sparing (NS) surgical plan in prostate cancer (PCa) patients referred to robot assisted radical prostatectomy (RARP) Methods: 137 consecutive PCa patients were submitted to RARP between September 2016 and February 2017 at two high-volume European centers. Before RARP, each patient was referred to 1.5-T or 3.0 T mpMRI. NS was recorded as Grade 1, Grade 2, Grade 3 and Grade 4 according to Tewari et al.11 classification. A preliminary surgical plan to determinate the extent of NS approach was recorded basing on clinical data. The final surgical plan was re-assessed after mp-MRI revision. The appropriateness of surgical plan change was considered basing on the presence of ECE or positive surgical margins (PSMs) at level of NVBs area at final pathology. Furthermore, we analyzed a control group during the same period of 166 PCa patients referred to RARP in both institutions without preoperative mpMRI to assess the impact of the use of mpMRI on the surgical margins.