January 30, 2012

Reducing Nerve Damage in Prostate Cancer Surgery

(Ivanhoe Newswire) -- A new study suggests that Preoperative MRI may help surgeons make better decisions about procedures that may cause nerve damage in men with prostate cancer.

"I think preoperative MRI will be useful for surgeons who are uncertain whether to spare or resect the nerves. Our surgeons feel that, compared with clinical information alone, MRI is worthwhile for all patients, because it identifies important information leading to a change in the surgical plan in almost a third of patients," assistant professor of radiology at the David Geffen School of Medicine at the University of California Los Angelos, Daniel J.A. Margolis, M.D., was quoted as saying,

Robotic-assisted laparoscopic prostatectomy (RALP) is a surgery that makes smaller incisions than open radical prostatectomy in the belly through robotic arms in order to make a delicate process more precise. The main goal of RALP is to remove all cancer. However, a serious risk in this kind of surgery is possible nerve damage. By performing RALP, tactile feedback is lacking and may compromise the surgeon's ability to evaluate bundles of nerves that are linked to the prostate, which includes the nerves directly linked to a man's ability to get an erection (Source: webmd.com). Dr. Margolis' research may have found a way to improve preoperative assessment of prostate cancer and the involvement of neurovascular bundles.

The study evaluated 104 male patients with prostate cancer who underwent RALP and preoperative endorectal coil MRI of the prostate. They recorded the differences in the surgical plan before and after review of the MRI report and compared those to the surgical results. They found that Preoperative MRI data changed the decision to use a nerve-sparing decision in 27% of patients; the surgical plan was changed to nerve-sparing technique in 61%; and a non-nerve-sparing technique was changed in 39% of patients.

"There is a learning curve for prostate MRI. What we and others have found is that one has to select patients where there is likely to be a benefit from the imaging," Dr. Margolis, M.D., was quoted as saying,

SOURCE: Radiology, January 2012