{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:20:05Z","timestamp":1791264005784,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"23","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Magnetic resonance imaging (MRI) findings are not currently included in prostate cancer (PC) staging. Yet the presence of MRI\u2010detected extraprostatic extension (EPE) may indicate higher risk disease. The purpose of this study was to assess the prevalence of MRI\u2010EPE and prognostic ability in localized PC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with T1\u2010T2N0M0 PC diagnosed between 2000 and 2021 having a prostate MRI before definitive treatment were identified from the Veterans Affairs Prostate Data Core. MRI reports were assessed for major capsule abutment (MCA), extracapsular extension (ECE), seminal vesicle invasion (SVI), or organ invasion (OI). Any of these findings were considered EPE. Predictors of MRI\u2010detected EPE were assessed with a multivariable logistic regression. The impact of MRI findings on distant metastasis (DM) by multivariable Fine\u2010Gray competing\u2010risks regression was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 2275 patients were included. Most pretreatment MRIs (85%) occurred after 2016. Approximately half the patients were Black. A total of 480 (21%) patients had palpable disease. Median follow\u2010up time was 5.1 years. The 5\u2010year cumulative incidence of metastasis was 4.8% (95% confidence interval [CI] 3.9%\u20135.7%). MRI indicated 468 (21%) patients had EPE: MCA (7%), ECE (10%), SVI (3%), and OI (1%). On multivariable analysis, the presence of MCA, ECE, SVI, and OI were each independently associated with worse DM. Findings of a digital rectal examination were also prognostic. Limitations included lack of centralized review of MRI images.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MRI\u2010detected EPE, including MCA, is common in localized PC and independently prognostic. MRI findings should be considered in the next iteration of PC staging.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70191","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T13:34:33Z","timestamp":1764077673000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prognostic significance of magnetic resonance imaging\u2010detected extraprostatic extension in localized prostate cancer"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2306-8863","authenticated-orcid":false,"given":"Abhishek","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1713-9538","authenticated-orcid":false,"given":"Dominic 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