Preoperative Magnetic Resonance (MR) Imaging of Prostate Cancer
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Purpose
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.
| Condition | Intervention |
|---|---|
|
Prostate Cancer |
Other: Preoperative MRI |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Clinical Impact of MR Imaging in Patients With Prostate Cancer |
- Surgical margins [ Time Frame: 30 days ] [ Designated as safety issue: No ]The surgical margins are assessed by evaluating the pathological specimen
- Surgical decision process [ Time Frame: 30 days ] [ Designated as safety issue: No ]Evaluated using questionaire
- Preoperative TNM classification [ Time Frame: 1-4 weeks ] [ Designated as safety issue: No ]Based upon preoperative MRI
- Detection of Gleason grade 4 and 5 [ Time Frame: 30 days ] [ Designated as safety issue: No ]
- Functional outcome [ Time Frame: 1 year after prostatectomy ] [ Designated as safety issue: No ]Evaluate the functional outcome in respect to erectile dysfunction.
| Enrollment: | 400 |
| Study Start Date: | November 2009 |
| Study Completion Date: | July 2012 |
| Primary Completion Date: | July 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
No Intervention: No preoperative MRI
control arm of the study
|
|
|
Active Comparator: MRI group
preoperative MRI
|
Other: Preoperative MRI
Preoperative staging
|
Detailed Description:
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) if preoperative MRI can determine tumor localization, size, 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.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Male |
| Accepts Healthy Volunteers: | No |
Inclusion criteria
- All patients suitable for surgery.
- Positive biopsy (Gleason grade >3).
- Informed consent.
Exclusion Criteria:
- Patients who do not sign the consent paper for any reason or do not accept the study premises.
- Patents who want to withdraw for any reason during the study.
- Patients with contraindications to MRI (pacemaker, claustrophobia etc) and/or surgery.
- Patients who have undergone a high quality MRI examination of the prostate at another radiological center. In this situation the MR examination is evaluated together with the surgeon but the patient is not included in the study. (In case of a low quality examinations, we will disregard the findings, and include the patient).
- If the surgeon finds it unacceptable to perform RALP without MRI, because of various reasons (eg. patient demand, too high risk etc) the patient will not be included in the study.
- If preoperative MRI reveals extensive tumor invasion into adjacent organ (T4) or skeletal metastases (M1), as these cancer stadiums do not benefit from RALP.
Contacts and Locations
More Information
No publications provided
| Responsible Party: | Erik Rud, MD, Oslo University Hospital |
| ClinicalTrials.gov Identifier: | NCT01347320 History of Changes |
| Other Study ID Numbers: | OsloUH |
| Study First Received: | March 9, 2010 |
| Last Updated: | August 16, 2012 |
| Health Authority: | Norway: Ethics Committee |
Keywords provided by Oslo University Hospital:
|
Prostate cancer preoperative staging MRI Free surgical margins |
Additional relevant MeSH terms:
|
Prostatic Neoplasms Genital Neoplasms, Male Urogenital Neoplasms Neoplasms by Site |
Neoplasms Genital Diseases, Male Prostatic Diseases |
ClinicalTrials.gov processed this record on May 19, 2013