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 language | English (US) |
|---|---|
| Pages (from-to) | 254-260 |
| Number of pages | 7 |
| Journal | Human Pathology |
| Volume | 43 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 2012 |
| Externally published | Yes |
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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 journal › Article
}
TY - JOUR
T1 - Characteristics of positive surgical margins in robotic-assisted radical prostatectomy, open retropubic radical prostatectomy, and laparoscopic radical prostatectomy
T2 - A comparative histopathologic study from a single academic center
AU - Albadine, Roula
AU - Hyndman, Matthew E.
AU - Chaux, Alcides
AU - Jeong, J. Y.
AU - Saab, Shahrazad
AU - Tavora, Fabio
AU - Epstein, Jonathan I.
AU - Gonzalgo, Mark L
AU - Pavlovich, Christian P.
AU - Netto, George J.
PY - 2012/2
Y1 - 2012/2
N2 - 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.
AB - 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.
KW - Biochemical recurrence
KW - Laparoscopic prostatectomy
KW - Prostate cancer
KW - Radical prostatectomy
KW - Robotic prostatectomy
KW - Surgical margin
UR - http://www.scopus.com/inward/record.url?scp=84855993358&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84855993358&partnerID=8YFLogxK
U2 - 10.1016/j.humpath.2011.04.029
DO - 10.1016/j.humpath.2011.04.029
M3 - Article
VL - 43
SP - 254
EP - 260
JO - Human Pathology
JF - Human Pathology
SN - 0046-8177
IS - 2
ER -