Obese men undergoing radical prostatectomy: Is robotic or retropubic better to limit positive surgical margins? Results from SEARCH.

International Journal of Urology : Official Journal of the Japanese Urological Association
Farnoosh Nik-AhdStephen J Freedland

Abstract

To evaluate the association between obesity and positive surgical margins in patients undergoing retropubic radical prostatectomy versus robotic-assisted laparoscopic prostatectomy. We retrospectively reviewed the data of 3141 men undergoing retropubic radical prostatectomy and 1625 undergoing robotic-assisted laparoscopic prostatectomy between 1988 and 2017 at eight Veterans Health Administration hospitals. The positive surgical margin location (peripheral, apical, bladder neck, overall) was determined from pathology reports. We adjusted for age, race, prostate-specific antigen, surgery year, prostate weight, pathological grade group, extracapsular extension, seminal vesicle invasion, hospital surgical volume and surgical method (in analyses not stratified by surgical method). Interactions between body mass index and surgical approach were tested. Among all patients, higher body mass index was associated with increased odds of overall, peripheral and apical positive surgical margins (OR 1.02-1.03, P ≤ 0.02). Although not statistically significant, there was a trend between higher body mass index and increased odds of bladder neck positive surgical margins (OR 1.03, P = 0.09). Interactions between body mass index and surgical m...Continue Reading

References

Dec 24, 2003·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Stephen J FreedlandMartha K Terris
Jul 16, 2005·Scandinavian Journal of Urology and Nephrology. Supplementum·Jonathan I EpsteinRodolfo Montironi
Oct 12, 2005·The Journal of Urology·Stephen J FreedlandAlan W Partin
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Dec 12, 2012·European Urology·Emma H AllottStephen J Freedland
Feb 15, 2014·The American Journal of Surgical Pathology·Jason P IzardJonathan L Wright
Jan 1, 2008·Journal of Robotic Surgery·Laura E CrocittoRebecca A Nelson
Dec 26, 2018·European Urology·Melissa AsselAndrew J Vickers

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Citations

Jul 19, 2020·International Journal of Urology : Official Journal of the Japanese Urological Association·Teruo Inamoto, Haruhito Azuma

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