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.
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.