Linear extent of positive surgical margin impacts biochemical recurrence after robot-assisted radical prostatectomy in a high-volume center

2020 ◽  
Vol 14 (4) ◽  
pp. 663-675 ◽  
Author(s):  
Antonio Benito Porcaro ◽  
Alessandro Tafuri ◽  
Marco Sebben ◽  
Nelia Amigoni ◽  
Aliasger Shakir ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Biochemical Recurrence ◽  
Surgical Margin ◽  
High Volume ◽  
Positive Surgical Margin ◽  
Robot Assisted ◽  
Linear Extent ◽  
High Volume Center

scholarly journals Prediction of a positive surgical margin and biochemical recurrence after robot-assisted radical prostatectomy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ching-Wei Yang ◽  
Hsiao-Hsien Wang ◽  
Mohamed Fayez Hassouna ◽  
Manish Chand ◽  
William J. S. Huang ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Biochemical Recurrence ◽  
Multivariable Analysis ◽  
Specific Antigen ◽  
Surgical Margin ◽  
Asian Population ◽  
Nerve Sparing ◽  
Positive Surgical Margin ◽  
Robot Assisted ◽  
Surgeon Experience

AbstractThe positive surgical margin (PSM) and biochemical recurrence (BCR) are two main factors associated with poor oncotherapeutic outcomes after prostatectomy. This is an Asian population study based on a single-surgeon experience to deeply investigate the predictors for PSM and BCR. We retrospectively included 419 robot-assisted radical prostatectomy cases. The number of PSM cases was 126 (30.1%), stratified as 22 (12.2%) in stage T2 and 103 (43.6%) in stage T3. Preoperative prostate-specific antigen (PSA) > 10 ng/mL (p = 0.047; odds ratio [OR] 1.712), intraoperative blood loss > 200 mL (p = 0.006; OR 4.01), and postoperative pT3 stage (p < 0.001; OR 6.901) were three independent predictors for PSM while PSA > 10 ng/mL (p < 0.015; hazard ratio [HR] 1.8), pT3 stage (p = 0.012; HR 2.264), International Society of Urological Pathology (ISUP) grade > 3 (p = 0.02; HR 1.964), and PSM (p = 0.027; HR 1.725) were four significant predictors for BCR in multivariable analysis. PSMs occurred mostly in the posterolateral regions (73.8%) which were associated with nerve-sparing procedures (p = 0.012) while apical PSMs were correlated intraoperative bleeding (p < 0.001). A high ratio of pT3 stage after RARP in our Asian population-based might surpass the influence of PSM on BCR. PSM was less significant than PSA and ISUP grade for predicting PSA recurrence in pT3 disease. Among PSM cases, unifocal and multifocal positive margins had a similar ratio of the BCR rate (p = 0.172) but ISUP grade > 3 (p = 0.002; HR 2.689) was a significant BCR predictor. These results indicate that PSA and pathological status are key factors influencing PSM and BCR.

scholarly journals Prediction of A Positive Surgical Margin and Biochemical Recurrence After Robot-Assisted Radical Prostatectomy 

2021 ◽  
Author(s):  
Ching-Wei Yang ◽  
Hsiao-Hsien Wang ◽  
Mohamed Hassouna ◽  
Manish Chand ◽  
Hsiao-Jen Chung
Keyword(s):  
Multivariate Analysis ◽  
Radical Prostatectomy ◽  
Biochemical Recurrence ◽  
Specific Antigen ◽  
Surgical Margin ◽  
Positive Surgical Margin ◽  
Intraoperative Blood Loss ◽  
Pathological Stage ◽  
Robot Assisted

Abstract A positive surgical margin (PSM) detected in a prostatectomy specimen is associated with poor oncotherapeutic outcomes. Certain aspects regarding the determination of surgical margins and their effects on biochemical recurrence (BCR) remain unclear. This study investigated the predictive factors for PSM and BCR. We prospectively included 419 robot-assisted radical prostatectomy cases. The number of PSM cases was 126 (30.1%), stratified as 22 (12.2%) in stage T2 and 103 (43.6%) in stage T3. Preoperative prostate-specific antigen (PSA) > 10 ng/mL (p = 0.047; odds ratio [OR] 1.712), intraoperative blood loss > 200 mL (p = 0.006; OR 4.01), and postoperative pT3 stage (p < .001; OR 6.901) were three independent predictors for PSM in multivariate analysis. PSA > 10 ng/mL (p < 0.015; hazard ratio [HR] 1.8), pT3 stage (p = 0.012; HR 2.264), ISUP grade > 3 (p = 0.02; HR 1.964), and PSM (p = 0.027; HR 1.725) were four significant predictors for BCR in multivariate analysis. Among PSM cases, ISUP grade > 3 (p = 0.002; HR 2.689) was a significant BCR predictor. These results indicate that PSA level and pathological stage markedly influence the PSM and BCR.

Positive Surgical Margin Trends In Patients With Pathologic T3 Prostate Cancer Treated With Robot Assisted Radical Prostatectomy

2014 ◽  
pp. 150127063130004 ◽  
Author(s):  
Andrew J. Lightfoot ◽  
Yu-Kai Su ◽  
Shailen Shivam Sehgal ◽  
Ziho Lee ◽  
Giovanni H. Greaves ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Surgical Margin ◽  
Positive Surgical Margin ◽  
Robot Assisted

scholarly journals Oncological and functional outcomes of 722 robot-assisted radical prostatectomy (RARP) cases: The largest Canadian 5-year experience

2014 ◽  
Vol 8 (5-6) ◽  
pp. 195 ◽  
Author(s):  
Kevin Christopher Zorn ◽  
Côme Tholomier ◽  
Marc Bienz ◽  
Pierre-Alain Hueber ◽  
Quoc Dien Trinh ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Functional Outcomes ◽  
Surgical Margin ◽  
High Volume ◽  
Oncologic Outcomes ◽  
Urinary Continence ◽  
Positive Surgical Margin ◽  
Transfusion Rate ◽  
Robotic Assisted Radical Prostatectomy

Introduction: While RARP (robotic-assisted radical prostatectomy) has become the predominant surgical approach to treat localized prostate cancer, there is little Canadian data on its oncological and functional outcomes. We describe the largest RARP experience in Canada.Methods: Data from 722 patients who underwent RARP performed by 7 surgeons (AEH performed 288, TH 69, JBL 23, SB 17, HW 15, QT 7, and KCZ 303 patients) were collected prospectively from October 2006 to December 2013. Preoperative characteristics, as well as postoperative surgical and pathological outcomes, were collected. Functional and oncological outcomes were also assessed up to 72 months postoperative.Results: The median follow-up (Q1-Q3) was 18 months (9-36). The D’Amico risk stratification distribution was 31% low, 58% intermediate and 11% high-risk. The median operative time was 178 minutes (142-205), blood loss was 200 mL (150-300) and the postoperative hospital stay was 1 day (1-23). The transfusion rate was only 1.0%. There were 0.7% major (Clavien III-IV) and 10.1% minor (Clavien I-II) postoperative complications, with no mortality. Pathologically, 445 men (70%) were stage pT2, of which 81 (18%) had a positive surgical margin (PSM). In addition, 189 patients (30%) were stage pT3 and 87 (46%) with PSM. Urinary continence (0-pads/day) returned at 3, 6, and 12 months for 68%, 80%, and 90% of patients, respectively. Overall, the potency rates (successful penetration) for all men at 6, 12, and 24 months were 37%, 52%, and 59%, respectively. Biochemical recurrence was observed in 28 patients (4.9%), and 14 patients (2.4%) were referred for early salvage radiotherapy. In total, 49 patients (8.4%) underwent radiotherapy and/or hormonal therapy.Conclusions: This study shows similar results compared to other high-volume RARP programs. Being the largest RARP experience in Canada, we report that RARP is safe with acceptable oncologic outcomes in a Canadian setting.

Length of Positive Surgical Margin After Radical Prostatectomy as a Predictor of Biochemical Recurrence

2009 ◽  
Vol 182 (1) ◽  
pp. 139-144 ◽  
Author(s):  
Sergey Shikanov ◽  
Jie Song ◽  
Cassandra Royce ◽  
Hikmat Al-Ahmadie ◽  
Kevin Zorn ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Biochemical Recurrence ◽  
Surgical Margin ◽  
Positive Surgical Margin
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