Positive surgical margins during robotic radical prostatectomy: a contemporary analysis of risk factors.

BJU International
Michael LissDavid Ornstein

Abstract

To determine the risk factors (clinical, pathological and technical) for positive surgical margins (PSMs) after robotically assisted radical prostatectomy (RARP), as a PSM is associated with an increased risk of biochemical recurrence and often responsible for significant patient anxiety. Between November 2003 and March 2007, 216 consecutive patients had an RARP by one fellowship-trained urological oncologist. The surgical pathological specimens were fixed and processed using standard techniques, and assessed by a pathologist at the same institution. A PSM was defined as the presence of cancer adjacent to the inked margin. The clinical charts were reviewed retrospectively under an approved institutional review board protocol. Univariable and multivariable methods, including logistic regression models, were used to analyse the clinical, pathological and technical risk factors for PSM. The overall prevalence of PSM was 14.8% (32/216), and 5.4% (8/149) for pT2 cancers. The only preoperative factor that was associated with a greater risk of a PSM was the serum prostate-specific antigen (PSA) level (P = 0.012) and PSA density (P = 0.005). Age, clinical stage and clinical Gleason grade were not predictors of a PSM. The overall and pT...Continue Reading

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Citations

Dec 4, 2008·Asian Journal of Andrology·Prokar Dasgupta, Roger S Kirby
Feb 7, 2012·Journal of Endourology·G Joel DeCastroGregory P Zagaja
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