In this issue of JAMA Oncology, Agrotis et al present a systematic review and meta-analysis of 40 studies (N = 24 941 patients) evaluating whether preoperative prostate magnetic resonance imaging (MRI) provides prognostic information in men undergoing radical prostatectomy. Using pooled hazard ratios (HRs) from multivariable, time-to-event models, Agrotis et al demonstrated that MRI-detected extraprostatic extension (mrT3a disease) (hazard ratio [HR], 2.16 [95% CI, 1.84-2.54]), seminal vesicle invasion (HR, 2.74 [95% CI, 2.06-3.65]), Prostate Imaging Reporting and Data System score of 4 or 5 (HR, 2.15 [95% CI, 1.82-2.55]), large tumor diameter (HR, 2.35 [95% CI, 1.71-3.24]), and low apparent diffusion coefficient values (HR, 2.39 [95% CI, 1.82-3.14]) were each independently associated with biochemical recurrence after adjusting for established clinical and pathological prognostic factors including prostate-specific antigen (PSA) and biopsy grade group. More limited but compelling data extend these associations to metastatic progression and prostate cancer–specific mortality.
JAMA Oncology published a clinical update in Oncology on 02 Apr 2026.
The item focuses on Prostate MRI Beyond Diagnosis.
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