Characteristics of positive surgical margins in robotic-assisted radical prostatectomy, open retropubic radical prostatectomy, and laparoscopic radical prostatectomy

A comparative histopathologic study from a single academic center

Roula Albadine, Matthew E. Hyndman, Alcides Chaux, J. Y. Jeong, Shahrazad Saab, Fabio Tavora, Jonathan I. Epstein, Mark L Gonzalgo, Christian P. Pavlovich, George J. Netto

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Studies detailing differences in positive surgical margin among open retropubic radical prostatectomy, laparoscopic radical prostatectomy, and robotic-assisted laparoscopic radical prostatectomy are lacking. A retrospective review of all prostatectomies with positive surgical margin performed at our center in 2007 disclosed 99 cases, 6 (5%) of which were reinterpreted cases as having negative margins. Ninety-three cases were, therefore, included, corresponding to 37 retropubic radical prostatectomies, 19 laparoscopic radical prostatectomies, and 37 robotic-assisted laparoscopic radical prostatectomies. The relationship of positive surgical margin characteristics to clinicopathologic parameters and biochemical recurrence was assessed. The most commonly found positive surgical margin site was the apex/distal third in all groups (62% retropubic prostatectomies, 79% laparoscopic prostatectomies, 60% robotic-assisted prostatectomies). Total linear length of positive surgical margin sites was significantly correlated with preoperative prostate-specific antigen, preoperative prostate-specific antigen density, pT stage, and tumor volume (P ≤.001). We found no significant differences among the 3 groups with respect to total linear length, number of foci, laterality, or location of positive surgical margin. The rate of biochemical recurrence was also comparable in the 3 groups. On univariate analyses, biochemical recurrence was significantly associated with preoperative prostate-specific antigen values, preoperative prostate-specific antigen density, Gleason score, number of positive surgical margins, and total linear length of positive surgical margin (P ≤.02). Only preoperative prostate-specific antigen density and number of positive surgical margin foci were statistically significant (P ≤.03) independent predictors of biochemical recurrence. We found no significant difference in positive surgical margin characteristics or biochemical recurrence among the 3 radical prostatectomy modalities. Preoperative prostate-specific antigen density and number of positive surgical margin foci were the only independent predictors of biochemical recurrence.

Original languageEnglish (US)
Pages (from-to)254-260
Number of pages7
JournalHuman Pathology
Volume43
Issue number2
DOIs
StatePublished - Feb 2012
Externally publishedYes

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Robotics
Prostatectomy
Prostate-Specific Antigen
Recurrence
Margins of Excision
Neoplasm Grading
Tumor Burden

Keywords

  • Biochemical recurrence
  • Laparoscopic prostatectomy
  • Prostate cancer
  • Radical prostatectomy
  • Robotic prostatectomy
  • Surgical margin

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Characteristics of positive surgical margins in robotic-assisted radical prostatectomy, open retropubic radical prostatectomy, and laparoscopic radical prostatectomy : A comparative histopathologic study from a single academic center. / Albadine, Roula; Hyndman, Matthew E.; Chaux, Alcides; Jeong, J. Y.; Saab, Shahrazad; Tavora, Fabio; Epstein, Jonathan I.; Gonzalgo, Mark L; Pavlovich, Christian P.; Netto, George J.

In: Human Pathology, Vol. 43, No. 2, 02.2012, p. 254-260.

Research output: Contribution to journalArticle

Albadine, Roula ; Hyndman, Matthew E. ; Chaux, Alcides ; Jeong, J. Y. ; Saab, Shahrazad ; Tavora, Fabio ; Epstein, Jonathan I. ; Gonzalgo, Mark L ; Pavlovich, Christian P. ; Netto, George J. / Characteristics of positive surgical margins in robotic-assisted radical prostatectomy, open retropubic radical prostatectomy, and laparoscopic radical prostatectomy : A comparative histopathologic study from a single academic center. In: Human Pathology. 2012 ; Vol. 43, No. 2. pp. 254-260.
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abstract = "Studies detailing differences in positive surgical margin among open retropubic radical prostatectomy, laparoscopic radical prostatectomy, and robotic-assisted laparoscopic radical prostatectomy are lacking. A retrospective review of all prostatectomies with positive surgical margin performed at our center in 2007 disclosed 99 cases, 6 (5{\%}) of which were reinterpreted cases as having negative margins. Ninety-three cases were, therefore, included, corresponding to 37 retropubic radical prostatectomies, 19 laparoscopic radical prostatectomies, and 37 robotic-assisted laparoscopic radical prostatectomies. The relationship of positive surgical margin characteristics to clinicopathologic parameters and biochemical recurrence was assessed. The most commonly found positive surgical margin site was the apex/distal third in all groups (62{\%} retropubic prostatectomies, 79{\%} laparoscopic prostatectomies, 60{\%} robotic-assisted prostatectomies). Total linear length of positive surgical margin sites was significantly correlated with preoperative prostate-specific antigen, preoperative prostate-specific antigen density, pT stage, and tumor volume (P ≤.001). We found no significant differences among the 3 groups with respect to total linear length, number of foci, laterality, or location of positive surgical margin. The rate of biochemical recurrence was also comparable in the 3 groups. On univariate analyses, biochemical recurrence was significantly associated with preoperative prostate-specific antigen values, preoperative prostate-specific antigen density, Gleason score, number of positive surgical margins, and total linear length of positive surgical margin (P ≤.02). Only preoperative prostate-specific antigen density and number of positive surgical margin foci were statistically significant (P ≤.03) independent predictors of biochemical recurrence. We found no significant difference in positive surgical margin characteristics or biochemical recurrence among the 3 radical prostatectomy modalities. Preoperative prostate-specific antigen density and number of positive surgical margin foci were the only independent predictors of biochemical recurrence.",
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