22.09.2026

Can advanced imaging further improve the precision of robot-assisted prostate cancer surgery?

Rochat CH, Schaffar R, Randriantsalama JM, Szalay IQ, de Boccard GA, Favre MM. Impact of preoperative MRI on surgical outcomes of robot-assisted laparoscopic prostatectomy: a single-center retrospective cohort of 844 patients. Ther Adv Urol. 2026 Jun 5;18:17562872261452717.

A large retrospective study by Charles-Henry Rochat et al. and involving 844 consecutive patients provided compelling evidence that the systematic use of preoperative multiparametric MRI (mpMRI) can significantly enhance surgical planning. By integrating detailed MRI findings into side-specific surgical strategies—including decisions regarding nerve-sparing procedures—surgeons achieved a substantial reduction in positive surgical margins, from 25% to 15%, despite operating on patients with less favorable disease characteristics.

The benefit was particularly pronounced in men with locally advanced (pT3) tumors, where accurate preoperative assessment is critical for balancing oncological control with preservation of function. Although early biochemical recurrence rates did not differ significantly after adjustment for baseline risk, the study demonstrates the important contribution of mpMRI to surgical precision in an experienced robotic program.

These findings support the routine integration of advanced imaging into prostate cancer surgery and point toward the next generation of 3D MRI-guided surgical planning, which may further optimize both cancer control and the preservation of urinary and sexual function.

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