Performance of MRI-Based vs Clinical T Staging in Localized Prostate Cancer

Does magnetic resonance imaging (MRI)–based T staging provide equivalent discrimination compared with traditional digital rectal examination (DRE) staging for men undergoing radical prostatectomy?This case-control study of 4425 men with advanced prostate cancer found that MRI-based staging demonstrated similar discrimination to DRE-based staging for estimating biochemical recurrence–free, distant metastasis–free, and overall survival, with largely overlapping C index 95% CIs across 4 major risk classification systems.This study’s results suggest that MRI-derived staging may replace DRE staging without compromising accuracy, supporting its integration into contemporary risk models in the modern prostate cancer diagnostic pathway.

Corresponding Author: Arthur Peyrottes, MD, MSc, Department of Urology, Hôpital Saint-Louis, Assistance Publique–Hôpitaux de Paris, Université Paris Cité, 1 avenue Claude Vellefeux, 75010, Paris, France (arthur.peyrottes@aphp.fr).

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