Prognostic Factors for Recurrence and Progression in Korean Non-Muscle-Invasive Bladder Cancer Patients: A Retrospective, Multi-Institutional Study

PURPOSE: To identify the prognostic factors related to tumor recurrence and progression in Korean patients with non-muscle-invasive bladder cancer (NMIBC). MATERIALS AND METHODS: Data were collected and analyzed for 2412 NMIBC patients from 15 centers who were initially diagnosed after transurethral resection of bladder tumor (TURBT) from January 2006 to December 2010. Using univariable and multivariable Cox proportional hazards models, the prognostic value of each variable was evaluated for the time to first recurrence and progression. RESULTS: With a median follow-up duration of 37 months, 866 patients (35.9%) experienced recurrence, and 137 (5.7%) experienced progression. Patients with recurrence had a median time to the first recurrence of 10 months. Multivariable analysis conducted in all patients revealed that preoperative positive urine cytology (PUC) was independently associated with worse recurrence-free survival [RFS; hazard ratio (HR) 1.56; p<0.001], and progression-free survival (PFS; HR 1.56; p=0.037). In particular, on multivariable analysis conducted for the high-risk group (T1 tumor/high-grade Ta tumor/carcinoma in situ), preoperative PUC was an independent predictor of worse RFS (HR 1.73; p<0.001) and PFS (HR 1.96; p=0.006). On multivariable analysis in patients with T1 high-grade (T1HG) cancer (n=684), better RFS (HR 0.75; p=0.033) and PFS (HR 0.33; p<0.001) were observed in association with the administration of intravesical Bacillus Calmette-Guérin (BCG) induction therapy. CONCLUSION: A preoperative PUC result may adversely affect RFS and PFS, particularly in high-risk NMIBC patients. Of particular note, intravesical BCG induction therapy should be administered as an adjunct to TURBT in order to improve RFS and PFS in patients with T1HG cancer.

The Effectiveness of Simultaneous Renal Artery-vein Clamping during Laparoscopic Partial Nephrectomy on the Surgical Outcome / 대한비뇨기과학회지

PURPOSE: We wanted to compare the surgical outcomes of laparoscopic partial nephrectomy(LPN) performed with and without simultaneous artery-vein clamping. MATERIALS AND METHODS: Between April 2005 and December 2006, elective LPN was performed for 56 patients with renal tumors with using hilar clamping by a Satinsky clamp in 42(75%) patients, and with using artery-only or no clamping in the rest of the patients. The Satinsky and non-Satinsky groups were compared for their perioperative characteristics, the pathologic findings and the complication rate. The postoperative renal function was evaluated with measuring the serum creatinine and also by 99technetium labeled diethylenetetraminepentaacetic acid(DTPA) renal scanning. RESULTS: Renal cell carcinoma was diagnosed in 43(76.8%) patients and all had negative margins. There were no significant differences between the two groups for tumor size(2.1 vs. 2.0cm, respectively), the operative time(210.9 vs. 199.3 min, respectively) and the hospital stay(5.9 vs. 5.6 days, respectively). The mean warm ischemia time was longer when the Satinsky clamp was applied(38.5 vs. 21.9 min, respectively, p=0.03). The postoperative serum creatinine level and glomerular filtration rate(GFR) were 1.13mg/dl and 41.4ml/min/m2, respectively, in the Satinsky group and 1.17mg/dl and 33.5ml/min/m2, respectively, in the non-Satinsky group, without significant differences. The postoperative transfusion rate was lower in the Satinsky group(9.5 vs. 28.5%, respectively, p=0.28), although more pelvocalyceal system repair was done in the Satinsky group (47.6 vs. 7.7%, respectively, p=0.006). CONCLUSIONS: Simultaneous clamping of the renal artery and vein during LPN enables efficient removal of tumors that are deep in the renal sinus with a safe margin, it facilitates closure of the pelvocalyceal system and it reduces the need for transfusion without impairing renal function.

Effect of Intravesical High Dose Epirubicin versus Bacillus Calmette-Guerin Instillation on the Recurrence and Progression of Superficial Bladder Cancer: A Prospective, Multicenter Study / 대한비뇨기과학회지

PURPOSE: To investigate the effects of intravesical high dose epirubicin instillation, the effect of epirubicin was compared with that of Bacillus Calmette-Guerin (BCG) instillation on the recurrence and progression of superficial bladder cancer. MATERIALS AND METHODS: Between September 1999 and February 2002, a total of 174 patients, who received an 8-week course of high dose epirubicin (80mg/50ml) or a 6-week course of BCG, following a complete transurethral resection for superficial bladder cancer, were followed up. The recurrence-free survival (RFS) and progression-free survival (PFS) rates were analyzed in each groups. RESULTS: There were no significant differences in the overall RFS and PFS between the two groups. In the high risk group, the RFS of the BCG group was significantly higher than that of the epirubicin group (p=0.014), whereas there was no significant difference in the PFS. In the intermediate risk group, there were no significant differences in the RFS and PFS. However, when those patients with a previous history of bladder cancer were excluded, the RFS was significantly higher in the epirubicin group (p= 0.0036). The incidence of local complications was higher in the high dose epirubicin group, but most of these were mild and self-limiting. CONCLUSIONS: Intravesical high dose epirubicin instillation in the high risk superficial bladder cancer group had no benefit over that of BCG instillation in terms of RFS and complications. However, high dose epirubicin could be a good alternative for patients in the intermediate risk group and, so it would seem, for those with a first occurrence.

The Effectiveness of Adjuvant Chemotherapy in the Transitional Cell Carcinoma of Urinary Bladder with Lymph Node Involvement Treated by Radical Cystectomy / 대한비뇨기과학회지

PURPOSE: To assess the impact of adjuvant chemotherapy on the survival of patients treated surgically for a bladder transitional cell carcinoma (TCC). MATERIALS AND METHODS: We retrospectively analyzed the data from 243 patients with bladder TCC who underwent a radical cystectomy. The mean age of the patients was 61.2 years, with a median follow-up of 46.8 months. The influence of prognostic factors, including age, gender, tumor stage, grade and chemotherapy, on the 5-year survival rate were analyzed. The difference in the survival rates among the prognostic factors were analyzed by univariate and multivariate analyses. RESULTS: The overall 5-year survival rate was 72%. The significant prognostic factors for the 5-year survival according to the univariate analysis were lymph node involvement, tumor stage, age and chemotherapy. From the multivariate analysis, lymph node involvement was the most independent of the prognostic factors for survival. Patients with lymph node involvement had a worse prognosis than those without (p<0.001). Adjuvant chemotherapy in patients with lymph node involvement had a great impact on survival (p=0.001). CONCLUSIONS: When treating a bladder TCC with a radical cystectomy, lymph node involvement, tumor stage, age and chemotherapy were significant factors influencing survival. Adjuvant chemotherapy will provide a therapeutic role in invasive bladder TCC, with lymph node involvement, following a radical cystectomy.

A Prospective Randomized Study Comparing Effectiveness of Local Anesthesia Techniques in Patients undergoing Transrectal Ultrasound-guided Prostate Biopsy / 대한비뇨기과학회지

PURPOSE: This study was designed to compare the effectiveness of intrarectal lidocaine gel versus periprostatic lidocaine injection during TRUS-guided biopsies. MATERIALS AND METHODS: From April 2003 to September 2003, 90 men undergoing a transrectal prostate biopsy were randomized into three groups. In group 1, 30 patients intrarectally received 20ml of 2% lidocaine gel; and group 2, 30 patients received 5ml(2.5ml per side) of 2% lidocaine solution injected along each side of the prostate, near the junction of the seminal vesicle and the base of the prostate(along the neurovascular bundles); in group 3, 30 patients received 5ml(2.5ml per side) of normal saline injected along the neurovascular bundles. The pain level after the biopsy was assessed using a 10-point linear visual analog pain scale(VAS). A statistical analysis was performed using the Wilcoxon Rank Sum test, and the results compared. RESULTS: Patient who received lidocaine solution injections along the neurovascular bundles (Group 2) had significantly lower VAS scores compared to the control group(mean score 3.56+/-2.13 versus 5.83+/-1.94, p<0.0001), but patients who received intrarectal lidocaine gel did not (mean score 5.46+/-2.70 versus 5.83+/-1.94, p=0.671). Gross hematuria, rectal bleeding and hemospermia occurred in 36(40.0%), 6(6.7%) and 5(5.6%) subjects, respectively. One patient had a vasovagal syncope. No patient reported febrile UTI or urinary retention. CONCLUSIONS: Bilateral nerve blockade with local anesthetic is a safe technique that significantly reduces pain during a prostate biopsy. However, in this study, intrarectal lidocaine injection did not reduce the pain compared to the control group during the prostate biopsy.

Prognostic Factors for Survival in the Renal Cell Carcinoma with Tumor Thrombus / 대한비뇨기과학회지

Purpose: To analyze various prognostic factors and surgical outcomes in patients who underwent radical nephrectomy and thrombectomy of a renal cell carcinoma with renal vein or inferior vena caval thrombosis. Materials and Methods: Among 44 patients with confirmed renal cell carcinomas and renal vein or inferior vena caval thrombosis, between December 1993 and June 2000, 42 having undergone radical nephrectomy and thrombectomy were retrospectively studied. 2 patients were excluded due to no operation performance. The 5-year disease-specific survival rates were analyzed according to various prognostic factors, including age, gender, clinical symptoms, tumor side (Rt. vs. Lt.), thrombus position (renal vein vs. IVC), histopathological cell type, lymph node involvement, pT stage irrespective of thrombus, Fuhrmann nuclear grade and invasion to perinephric fat, vessel, renal pelvis or adrenal gland. Results: The overall 5-year disease-specific survival rate of all the patients was 55%. A univariate analysis of the 42 patients showed that the position of the tumor thrombus, histopathological cell type and invasion to the adrenal gland had a significant impact on the survival. On multivariate analysis, the tumor thrombus location and histopathological cell type were independent prognostic factors for the survival. The 5-year disease-specific survival rates of the patients with a renal vein thrombus (n=23) and with IVC (inferior vena cava, n=20) were 75 and 20%, respectively. The 5-year disease-specific survival rate of the patients with a conventional cell type (n=32) was 68%, and patients with other pathologic cell types had no significant follow-up periods. Conclusions: The tumor thrombosis position, histopathological cell type and invasion to the adrenal gland are considered as clinically significant prognostic factors in patients with a renal cell carcinoma with vein thrombosis after radical nephrectomy with a thrombectomy. Meticulous radical nephrectomy with thrombectomy will be beneficial to the survival of patients with a renal cell carcinoma and vein thrombus.

Expression of Bcl-2 and Bax in cis-Diamminedichloroplatinum (II)-Resistant Bladder Cancer Cell Lines / 대한비뇨기과학회지

PURPOSE: Development of drug resistance has been the major obstacle in cis-Diamminedichloroplatinum (II) (cisplatin)-based combination chemotherapy in the treatment of advanced bladder cancer for which a variety of mechanisms has been suggested. We investigated to determine the changes of expression of apoptotic regulator proteins Bcl-2 and Bax in cisplatin-resistant bladder cancer cell lines and the reversibility of chemoresistance with antisense oligonucleotide against Bcl-2. MATERIALS AND METHODS: In T24, J82, 253J, 253J-BV and HT-1376 bladder cancer cell lines, we established cisplatin-resistance using stepwise exposure to cisplatin. The changes of Bcl-2 and Bax proteins in the resistant cell lines were determined by Western blot. Then, after administration of antisense oligonucleotide targeting the Bcl-2 coding sequence to the T24, T24-R1, and T24-R2 cell lines with lipofectamine, changes of Bcl-2 expression were determined along with cisplatin cytotoxicity before and after transfection. RESULTS: We confirmed the acquisition of cisplatin resistance in all 5 cell lines as the percent increase of IC50 in each cell lines were 210%, 175%, 181%, 280% and 153%, respectively. The expression of Bcl-2 protein increased in all 5 cisplatin-resistant cell lines, while the expressions of Bax decreased in 4 of 5 cisplatin-resistant cell lines. Treatment with antisense oligonucleotide significantly enhanced the cytotoxicity of cisplatin in T24, T24-R1 and T24-R2 cell lines. CONCLUSIONS: These results suggest that the up-regulation of Bcl-2 expression as well as down-regulation of Bax expression may be one of the mechanisms of cisplatin resistance in bladder cancer cells, and antisense Bcl-2 oligonucleotide may be helpful in chemotherapy of bladder cancer by reversing cisplatin resistance.

Comparative Analysis of Sextant and Extended Prostate Biopsy / 대한비뇨기과학회지

PURPOSE: To investigate whether the extended-core (eight- or ten-core) biopsy incorporating far lateral peripheral zone can increase the rate of prostate cancer detection compared to traditional sextant biopsy. MATERIALS AND METHODS: We retrospectively analyzed the results of prostate needle biopsies of 770 men with elevated serum prostate specific antigen (PSA) ranging from 4.1 to 20ng/ml. Ten-core, eight-core, and sextant biopsies were performed in 584, 111, and 75 men, respectively. There were no significant differences in age, mean level of serum PSA, prostate volume, and PSA density between extended biopsy group and sextant biopsy group. The cancer detection rate was compared between the two groups according to the range of PSA and finding of digital rectal examination (DRE). RESULTS: Overall cancer detection rate was 12.0% in sextant biopsy group and 18.3% in extended-core biopsy group (p>0.05). In men with abnormal DRE, there was no significant difference between the two groups in terms of the cancer detection rate (35.0% in sextant biopsy group versus 30.2% in extended biopsy group). However, significantly higher cancer detection rate was noted in extended-core biopsy group with normal findings of DRE (3.6% versus 12.7%). No significant difference of the cancer detection rate was observed between eight-core and ten-core biopsy groups. CONCLUSIONS: In men with an elevated PSA and a normal DRE, extended- core biopsy appears to enhance cancer detection compared to the traditional sextant biopsy, whereas sextant biopsy may be sufficient to detect the cancer in men with abnormal findings of DRE.

Nomograms for the Prediction of the Pathological Stage of the Clinically Localized Prostate Cancer in Korean Men / 대한비뇨기과학회지

PURPOSE: The data of Korean men with prostate cancer from a single institute were analyzed to construct nomograms predicting the pathological stage and to compare the outcomes with pre-existing nomograms. MATERIALS AND METHODS: A total of 254 Korean men, with clinically localized prostate cancer, who underwent radical retropubic prostatectomy at Asan Medical Center, between June 1990 and April 2002, were included in this study. A multinomial log-linear regression analysis was performed for the simultaneous prediction of organ-confined disease(OC), seminal vesicle invasion(SVI) or lymph node metastasis(LN) using serum PSA, Gleason scores and clinical stages. Nomograms representing the percentage probabilities were constructed, and compared with the preexisting nomograms presented in the work of Partin et al. and Egawa et al., by calculating the area under the receiver operating characteristics(ROC) curves. RESULTS: Nomograms predicting the likelihood of OC, SVI and LN were derived from the combination of the aforementioned preoperative variables. When the nomograms were compared using the ROC curves, with the Partin table, the areas under the curves were 0.758, 0.762 and 0.766 for OC, SVI and LN, respectively, and with the Egawa table, 0.766 and 0.669 for OC and SVI, respectively. In the multiple measures analysis, which tested the differences between each corresponding data with respect to each preoperative variable, all the tested differences were revealed to be statistically significant. CONCLUSIONS: Comparison of the prediction nomograms revealed notable differences, especially in the OC and SVI. Therefore, it is recommended that each table should be applied to its corresponding population.

New Technique of Orthotopic Ileal Neobladder: Early Experience / 대한비뇨기과학회지

PURPOSE: During the last 10 years, a multitude of different ileal neobladders have been reported. The ureterointestinal anastomotic site stricture has been shown to be one of the most common late complications. To avoid the stricture, a new orthotopic ileal neobladder was constructed, with two chimneys and two afferent ileal limbs beside the reservoir. MATERIALS AND METHODS: Twenty-six men, with invasive bladder cancer, underwent a radical cystectomy, with the creation of a two chimney ileal neobladder. The mean follow-up was 18 months. The complications were assessed and divided into those related or unrelated to the urinary tract. The continence was evaluated using patient questionnaires. RESULTS: There was no case of an ureteroileal anastomotic site stricture. Five cases of vesicoureteral reflux were noted in the 52 ureteral units. Good, or satisfactory, day- and nighttime urinary continence was reported at the 6 month follow-up by 92.3 and 69.2% of patients, respectively. CONCLUSIONS: The ileal neobladder with two chimneys would be an appropriate technique for the reduction of the ureteroileal anastomotic stricture rate and to overcome some of limitations of the ureteral length.

Factors Modulating Responses to Immunochemotherapy in Advanced Renal Cell Carcinomas / 대한비뇨기과학회지

PURPOSE: Despite numerous trials no various immunochemotherapeutic agents, advanced renal cell carcinomas (RCC) remain highly resistant to treatment. We report the results of immunochemotherapy to evaluate its efficacy, and to investigate factors modulating responses to treatment. MATERIALS AND METHODS: In this retrospective analysis, 54 patients with advanced RCC, having received either interferon-alpha (IFN-alpha) monotherapy, or a combination of interleukin-2 (IL-2), 5-fluorouracil (5-FU) and vinblastine, with IFN-alpha between January 1999 and March 2001, were reviewed. The patients were divided into 2 groups, either single or combined, therapy groups, which were further subdivided into locally advanced and metastatic disease groups. The nephrectomy and performance stati, cancer stage at the beginning of the immunotherapy, metastasized organs and interval to metastasis, were considered, and the responses to treatment and survival were evaluated accordingly in each subgroup. RESULTS: Of the 54 patients, 39 received monotherapy, 34 of which had a metastatic disease. Partial remission was observed in 1 patient (2.9%) with a duration of response of 52 weeks, a median survival of 47 weeks (4-323 wks) and a 1 year survival rate of 41.2%. Of the 15 patients in the combined therapy group, 12 with a metastatic disease, complete remission was noted in 1 patient (8.3%), with a continuous response at 57 weeks, a median survival of 34 weeks (4-204 wks) and a 1 year survival rate 41.7%. Of the prognostic factors, the nephrectomy status proved to be the only significant factor improving survival. CONCLUSIONS: Advanced RCC exhibited a very limited response, and nephrectomy status was revealed to be the only significant factor affecting survival. The efficacy of immunotherapy on locally advanced RCC needs further controlled evaluative studies.

The Pathological Characteristics of Localized Prostate Cancer, Managed with Radical Prostatectomy / 대한비뇨기과학회지

PURPOSE: Prostate cancer is known as the most common cancer in western men, and their incidences are increasing in oriental men, including Koreans. We made an effort to evaluate the pathological characteristics of this cancer in Koreans. MATERIALS AND METHODS: The medical records of 170 patients with prostate cancer, having undergone a radical retropubic prostatectomy between April 1990 and May 2001 were reviewed. The distributions of preoperative serum PSA levels, preoperative biopsy Gleason scores and clinical stages were evaluated. We analyzed pathological findings, such as the rates of organ confinement, extracapsular extension, seminal vesicle invasion and lymph node involvement. In cases with seminal vesicle invasion, tumor mapping, through microscopic examination of histological sections at multiple levels, were performed to determine the route of invasion. RESULTS: When the patients were stratified according to each preoperative parameter, the largest proportion were found to be in the T1c and T2a clinical stages (40.6%), had Gleason scores between 8 and 10 (34.1%) and serum PSA levels in the range of 4-10ng/ml (32.9%). There were 30.6% of patients with preoperative serum PSA levels greater than 20ng/ml. The rates of organ confinement, extracapsular extension, seminal vesicle invasion and lymph node involvement were 54.7, 17.7, 19.4 and 8.2%, respectively. 75.8% of the seminal vesicle invasions were revealed to be from direct extension of the tumor. CONCLUSIONS: The high incidence of seminal vesicle invasion in Korean prostate cancer patients might be due to the location of the tumors, the aggressiveness of the tumors or racial differences. Considering the reported incidence of seminal vesicle invasion in Japan was 32%, multicentric studies are required to elucidate the cause of the high incidence of seminal vesicle invasion in Asians.

The Prognostic Value of Fuhrman Nuclear Grade, 1997 TNM Classification and cell Type in Renal Cell Carcinoma / 대한비뇨기과학회지

PURPOSE: It is agreed that tumor stage is the definitive prognostic indicator for patients with renal cell carcinoma. We investigated pathologic grade and cell subtype as another prognostic in each tumor stage. MATERIALS AND METHODS: We reviewed the medical records of 206 patients who underwent partial or radical nephrectomy for renal cell carcinoma between January 1991 and June 1998. Renal cell carcinoma grade, stage and cell subtype (conventional [clear cell], papillary, chromophobe, sarcomatoid type) were evaluated using the 1997 Union International Contre Ie cancer (UICC) and the American Joint Committee on Cancer (AJCC) grading, TNM staging criteria and renal cell carcinoma classification. Kaplan -Meier survival curves were used to determine 5-year survival for all patient groups. Univariate analysis using log rank test was performed to evaluate the prognostic significance of TNM stage, Fuhrman nuclear grade, cell subtype and tumor size. We investigated pathologic grade and cell subtype with log rank teat whether those were another significant prognostic factors in each tumor stage. Multivariate analysis was performed to determine which factors had an independent impact on survival of patients with renal cell carcinoma. RESULTS: Univariate analysis revealed that TNM stage (p<0.001), pathologic grad (p<0.001) were the important prognostic indicators for renal cell carcinoma. Survival was affected significantly by tumor size when cutoff diameter for localized T1 lesions was 7cm but not 2.5cm. Pathologic grade had a significant impact on patient survival (p<0.0001). In the cell subtype chromophobe type had the best survival and sarcomatoid type had the worst survival though cell subtype did not appear to affect survival significantly (p=0.0583). Multivariate analysis revealed that N classification (p=0.009) and M classification (p=0.018) were the most important prognostic indicators for cell subtype (p=0.841) were not shown to have any independent impact on patient survival. In the group of localized disease(TXN0M0 stage) at the diagnosis, cell subtype had a significant impact on survival in T1(p<0.001), T2(p=0.01) and T3(p=0.029) and grade in T1(p=0.0016) and T3(p=0.0054). CONCLUSIONS: Pathologic grade and cell subtype were significant predictors of survival in each T stage of localized disease though they didn't have independent impact on the patient survival.

Early and Late Complications of Radical Retropublic Prostatectomy / 대한비뇨기과학회지

No abstract available.

Endorectal Coli MRI in the Local Staging of Clinically Organ Confined Prostate Cancer / 대한비뇨기과학회지

No abstract available.

Laparoscopic Nephrectomy for Tuberculous Kidney / 대한비뇨기과학회지

No abstract available.

Prediction of Biochemical Failure after Radical Prostatectomy for Localized Prostate Cancer / 대한비뇨기과학회지

No abstract available.

Prediction of Biochemical Failure after Radical Prostatectomy for Localized Prostate Cancer / 대한비뇨기과학회지

No abstract available.

Prognostic factors of invasive bladder cancer / 대한내과학회지

Transitional cell carcinoma(TCC) of the bladder is confined to mucosa or submucosa on initial presentation. However, high grade superficial tumors tend to recur and progress to muscle invasive or metastatic diseases. Regardless of radical cystectomy in invasive bladder cancer, a poor prognosis was noted due to local recurrence and distant metastasis in recent studies. In this study, the clinical and pathological factors affecting survival of patients with muscle invasive bladder cancer were analyzed. METHODS: A total of 105 patients with histopathologically verified muscle invasive bladder cancer who were admitted to Asan Medical Center between August 1989 and August 1998 were reviewed retrospectively. The clinical manifestations, laboratory findings, and histopathological findings at initial diagnosis were evaluated. Overall survival, disease free survival, and disease specific survival according to many prognostic factors were also analyzed. RESULTS: The factors affecting overall survival of muscle invasive bladder cancer were age, sex, TNM stage, performance status, tumor size, invasion of deep bladder muscle, tumor grade, lymphovascular invasion, and complete resection of tumors. In patients with completely resected bladder cancer by radical cystectomy, tumor size, deep bladder muscle invasion, stage, and lymph node involvement were significant prognostic factors. In patients who had either incomplete resection of bladder cancer or in whom no operation was performed, the survival rate was lower in cases with lymph node involvement or hemoglobin level of less than 10 g/dl. CONCLUSION: After radical cystectomy, the recurrence rate appeared to be higher in solid tumors with deep bladder muscle invasion and lymphovascular invasion on cystoscopic findings. Overall survival was higher in patients with lower tumor stage, no lymph node involvement, and completely resected bladder cancer. Age and sex had no significant correlation with overall survival. No apparent survival advantage was noted in those patients who received post-operative chemotherapy. However, prospective randomized controlled studies are necessary to evaluate the benefit of adjuvant chemotherapy in muscle invasive bladder cancer.

Endorectal MRI of Prostate Cancer: Comparison with Findings on Radical Prostatectomy

PURPOSE: To assess the accuracy of magnetic resonance (MR) imaging using an endorectal surface coil ineval-uation of local lesions of prostate carcinoma. MATERIALS AND METHODS: Twenty patients with surgically provenprostate carcinoma underwent MR imaging using a 1.5T unit and an endorectal surface coil made at the Asan MedicalCenter. T1-weighted images in the axial plane and T2-weighted images in the axial, coronal, and sagittal planeswere obtained in all patients. We divided the prostate gland into right and left lobe, then determined thelocation of carcinoma within it, as well as capsular penetration and seminal vesicle invasion. MR images werecompared with surgical specimens. RESULTS: MR imaging using an endorectal surface coil accurately demonstratedthe staging of prostate carcino-ma in 60% of patients (12/20), but with regard to the location of carcinoma withinthe prostate gland, capsular penetration, and seminal vesicle invasion, only nine cases (45%) showed completeagreement between en-dorectal surface coil MR images and pathologic findings. The accuracy of localizing thecarcinoma within the prostate gland, capsular penetration, and seminal vesicle invasion were 65%(13/20),70%(14/20), and 90%(18/20), respectively. CONCLUSION: MR imaging using an endorectal surface coil for thelocalization of prostate carcinoma and periprostatic tissue invasion showed a low degree of accuracy. Morespecific imaging findings are therefore needed.