Evidence map›Paper›PMID 41483404›Full record

ArticleWorld journal of urology2026

Exploring the use of preoperative MRI for assessing the anatomical location of positive surgical margin at robot-assisted radical prostatectomy (RARP).

Sophia H van der Graaf, Thierry N Boellaard, André N Vis, Vera Sweere, Hans Veerman, Esther M K Wit, Ton A Roeleveld, Jakko A Nieuwenhuijzen, Henk G van der Poel, Pim J van Leeuwen

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Article in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Sophia H van der GraafDepartment of Urology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital (NCI-AVL), Amsterdam, The Netherlands. s.h.vandergraaf@amsterdamumc.nl.
Thierry N BoellaardDepartment of Radiology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (NCI-AVL), Amsterdam, The Netherlands.
André N VisDepartment of Urology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital (NCI-AVL), Amsterdam, The Netherlands.
Vera SweereDepartment of Urology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital (NCI-AVL), Amsterdam, The Netherlands.
Hans VeermanDepartment of Urology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital (NCI-AVL), Amsterdam, The Netherlands.
Esther M K WitDepartment of Urology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital (NCI-AVL), Amsterdam, The Netherlands.
Ton A RoeleveldDepartment of Urology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital (NCI-AVL), Amsterdam, The Netherlands.
Jakko A NieuwenhuijzenDepartment of Urology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital (NCI-AVL), Amsterdam, The Netherlands.
Henk G van der PoelDepartment of Urology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital (NCI-AVL), Amsterdam, The Netherlands.
Pim J van LeeuwenDepartment of Urology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital (NCI-AVL), Amsterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRobot-assisted radical prostatectomy (RARP) is an effective treatment for localized prostate cancer (PCa), but positive surgical margins (PSMs) occur in up to 22% cases. This study quantifies the relationship between the tumor location on preoperative MRI and PSM location on final pathology examination. MATERIAL AND

methodsWe retrospectively reviewed PCa patients who underwent both prostate MRI and RARP between January 1, 2022 and December 31, 2022. The RARP specimens were divided into 14 regions, and concordance between MRI-detected lesions (PIRADS > 2) and PSM locations was assessed.

resultsData from 464 patients revealed PSMS in 130 (28%) patients, totaling 187 PSMs. Concordance between tumor and PSM location was found in 152 PSMs (81%). Of these, 38% corresponded with a T3 lesion on MRI, and 72% showed pathological T3 at the PSM location. Most PSMs (46%) were at the apex. The median size was 6.0 mm (IQR 1.9-10.3). In contrast, 19% of PSMs were in regions without MRI-detected lesions, mainly located at the apex (43%) and bladder neck (29%). In this group, 34% had no positive biopsy on the corresponding side. PSMs in this group showed pathological T3 in 66% of cases. The median size was 3 mm (IQR 2.5-7.0 mm), and 46% had a pathological ISUP Gleason score ≥ 2.

conclusionThis study highlights the role of preoperative MRI assessment in predicting PSM locations during RARP. In 81% of cases, PSMs corresponded to MRI-detected lesions (PI-RADS > 2), suggesting that MRI can help by guiding surgical planning and potentially reduce PSM rates.

Indexed as

Magnetic Resonance ImagingMargins of ExcisionProstatectomyProstatic NeoplasmsRobotic Surgical ProceduresAgedHumansMaleMiddle AgedPreoperative CareRetrospective StudiesConcordanceMagnetic resonance imagingPositive surgical marginProstate cancerRobot-assisted radical prostatectomyTumor location

Identifiers

PMID41483404

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