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Surgical margin status of specimen and oncological outcomes after laparoscopic radical prostatectomy: experience after 400 procedures.

Abstract：

PURPOSE:To analyse the surgical margins status of prostatic glands, resected by laparoscopic radical prostatectomy (LRP) for prostate cancer, and to correlate it with biochemical free survival rate (BFSR). METHODS:Data were collected prospectively from 405 patients undergoing LRP from 2000 to 2009 at a single institution. Patients undergoing neoadjuvant and/or adjuvant therapy were excluded from the study. Three hundred patients matched all the criteria: 232 of these had negative surgical margins (NSM) and 68 positive surgical margins (PSM). The median follow-up was 62 months. PSM were classified based on the following: (a) the number of margins, monofocal and multifocal, (b) the location, apical or non-apical and (c) the extension, ≤2.8 mm or >2.8 mm. These data were then entered into a multivariate analysis. RESULTS:Overall BFSR rate was 67.6% in PSM group and 88.8% in NSM group (P < 0.001). We registered a HR of 3.78 in multivariate analysis (P < 0.001). In terms of the extension, BFSR in univariate survival analysis was 77.8% in ≤2.8 mm PSM and 38.9% in >2.8 mm PSM (P = 0.003), with a HR of 5.68 (P = 0.011) in multivariate analysis. BFSR was 59% for apical margins and 77% for non-apical margins (P = 0.038). In monofocal margins, BFSR was 73%, while 53% in multifocal (P = 0.014). CONCLUSIONS:We recommend careful evaluation of patients with PSM following LRP, especially if they are more than 2.8 mm, and in these cases, adjuvant therapy should be considered after radical surgery.

journal_name

World J Urol

journal_title

World journal of urology

authors

Porpiglia F,Fiori C,Manfredi M,Grande S,Poggio M,Bollito E,Papotti M,Scarpa RM

doi

10.1007/s00345-011-0711-2

subject

Has Abstract

pub_date

2012-04-01 00:00:00

pages

245-50

issue

2

eissn

0724-4983

issn

1433-8726

journal_volume

30

pub_type

杂志文章

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