Ethnic variation in pelvimetric measures and its impact on positive surgical margins at radical prostatectomy.
OBJECTIVE
We sought to evaluate the ethnic variation in pelvimetry and its impact as a predictor of positive surgical margins (PSM) at radical prostatectomy (RP).


METHODS
Preoperative MRI was performed in 482 Caucasian and 103 African American (AA) men undergoing RP without previous treatment from July 2003 to January 2005 and November 2001 to June 2007, respectively. We measured bony and soft tissue dimensions on magnetic resonance imaging (MRI) to evaluate the pelvic inlet, midplane, prostate size, and apical depth. Analysis of covariance was performed to determine the effect of ethnicity on the midpelvic area (MPA). We performed multivariate logistic regression analysis for prediction of overall and site-specific PSM.


RESULTS
AA men had a significantly steeper symphysis pubis angle (median, 43.1 vs. 41.3°, respectively, P = .001) and smaller MPA (median, 78.5 vs. 83.9 cm(2), respectively, P = .004). Ethnicity and BMI were found to have a significant effect on MPA. Apical depth of the prostate was identified as a significant independent predictor of apical PSM, with a more pronounced effect in AA men. Pelvimetric measures were not a significant predictor of other sites of PSM.


CONCLUSIONS
AA men have a significantly smaller MPA and steeper symphysis angle. The adverse impact of a deep pelvis, as measured by the apical prostatic depth on apical PSM was found to be greater in AA men. Evaluation of pelvic dimensions and prostate parameters in preoperative MRI may add to our understanding of their impact on surgical outcomes.
von Bodman
Christian
C
Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Matikainen
Mika P
MP
Yunis
Luis Herran
LH
Laudone
Vincent
V
Scardino
Peter T
PT
Akin
Oguz
O
Rabbani
Farhang
F
D001741:Black or African American; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010387:Pelvimetry; D010388:Pelvis / Q000033:anatomy & histology*; D011467:Prostate / Q000473:pathology; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000208:ethnology* / Q000473:pathology / Q000601:surgery*; D011631:Pubic Symphysis / Q000033:anatomy & histology; D044465:White People