Dr. Ash Tewari On Robotic Surgery + MRI

Prostate Forum recently spoke with Dr. Ash Tewari of Mt. Sinai in New York, NY about robotic surgery for prostate cancer. Below are his comments on MRI’s use in prostate cancer surgery. You can read the entire interview in Prostate Forum Volume 15 Number 6.

We asked: I have been told MRI is very useful during active surveillance. Do you find MRI useful in planning surgery? For example, would it help to know ahead of time if the capsule is penetrated or if the seminal vesicles are involved? I ask because I know some other surgical centers won’t operate on men with high Gleason grades, or with other high-risk features.

Dr. Tewari said: Imaging and pre-operative planning can both ensure that all the cancer is gone and ensure that the nerves that could be saved are saved. As my own data shows, I have been able to pre-operatively plan surgery using a computer-based algorithm that combines MRI imaging with information from the biopsy and clinical exam. As the data shows, by using this algorithm I have consistently less than 9% residual margin rates. For the last several years, almost every year, the incidence of cancer outside the prostate has been going up. While the cancers have become more and more aggressive, I am still able to get the same cancer control and sexual function results.


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