Impact of surgeon-defined capsular incision during radical prostatectomy on biochemical recurrence rates

Abstract

Intraoperative CapI occurs in a relevant number of RP and is more frequent during nerve-sparing procedure and open RP. However, there seems to be no impact of CapI and its extent on the incidence of early BCR.

Is “extreme” bladder neck preservation in robot-assisted radical prostatectomy a safe procedure?

“…capsular incision) were evaluated by microscopic and macroscopic pathological analysis. 9 To evaluate the safety of the eBNP, we compared the histopathologic data with those of a homogeneous similar cohort of 88 consecutive patients who underwent RARP without BNP.…”

“…In particular, when we performed an eBNP, a basal tumor was found close (<1 mm) to the BN area in 35.7% of cases. Focusing on the pathological features of these cases, extraprostatic extension of disease (pT3), high Gleason scores, 9,10 and lymph node involvement in most of them were demonstrated. In addition, multiple PSMs, not only close to the BN, were identified.…”

Prostatic capsular incision during radical prostatectomy has important oncological implications: a systematic review and meta‐analysis

“…Disease-specific factors such as preoperative PSA level and Tstage were not associated with increased risk of CapI. However, one study found that the risk of CapI in patients with Gleason score ≥4+4 was lower compared to those with Gleason score 3+3 (odds ratio [OR] 0.54, 95% CI 0.32-0.88; P = 0.013) [12], which would be consistent with surgeons being less likely to perform tight nerve-sparing in higher-risk disease.…”

“…Two additional articles were identified by screening the references of review articles. One relevant conference abstract was identified [11], but this was excluded as a duplicate full-text article was identified by the same authors [12]. Using the Mendeley Literature Manager software 152, duplicates were removed leaving 115 articles for title and abstract screening.…”

“…Two studies were excluded because they did not provide sufficient data [21,22]. One study was excluded because a histological confirmation of the presence of CapI was not provided [12]. A summary of the assessment of quality scores by the Newcastle-Ottawa scale, as well as the ROB assessment according to ROBINS-E of the eight studies included in the meta-analysis, is provided in the Supporting Information (Tables S2 and S3).…”