Reliability of Pelvic MRI in Predicting Pathological and Clinical Stage Prior to Radical Surgery for Bladder Cancer—Analysis of a Prospective Cohort

Abstract

Total of 67 patients had pathological T3a disease. Biochemical recurrence was defined as PSA ≥ 0.2. 32 (48%) patients had biochemical recurrence. These patients had salvage treatment at PSA relapse rather than adjuvant. 18 out of 32 patients received radiotherapy before their PSA reached 2 and 1 patient had subcapsular orchidectomy. Overall 3 out of 37 patients had progressive disease (1 lymph node, 2 bone metastases) requiring hormonal treatment. Hence in our study 96% had progression free survival and 100% disease specific survival. 5year biochemical recurrence free survival was 67%. The overall survival was 94%. Conclusions: Surgery alone can be sufficient for pT3a prostate cancer in selected cases. Salvage radiotherapy offers additional advantage to the patients without compromising oncological outcome. Hence, we may offer surgery as a first line of multimodality therapy to all suspected pT3a patients over radiotherapy ± hormones.