Influence of Nerve-Sparing (NS) Procedure during Radical Prostatectomy (RP) on Margin Status and Biochemical Failure

Palisaar, Rein-Jüri; Noldus, Joachim; Graefen, Markus; Erbersdobler, Andreas; Haese, Alexander; Huland, Hartwig

doi:10.1016/j.eururo.2004.09.002

Cited by 102 publications

(55 citation statements)

References 31 publications

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“…The positive margin rate in British Columbia in pT3 cases (57%) are also comparable to the range of regional rates seen in Ontario (42%-83%), 11 and within the ranges of rates reported in the literature (24%-80%). [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] In comparison to the recent large SEER series, need for, and use of, post prostatectomy radiotherapy our margin positive rates exceed those reported for SEER (18% for pT2, and 44% for pT3). 39 Unlike the SEER study, which was also population-based, our study detailed patient data on postoperative PSA, which allowed us to distinguish adjuvant and early salvage radiotherapy.…”

Section: Discussioncontrasting

confidence: 63%

The need for, and utilization of prostate-bed radiotherapy after radical prostatectomy for patients with prostate cancer in British Columbia

Tyldesley

Peacock

Morris

et al. 2012

CUAJ

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Introduction: Three randomized trials have demonstrated that post-radical prostatectomy (RP) radiotherapy decreases biochemical relapse for those with adverse pathology. Our purpose was to describe the incidence of pathologic risk factors for recurrence in a contemporary series of patients treated with RP and to describe the use of post-RP radiotherapy. Methods: All incident prostate cancers diagnosed between January 2005 and December 2007 were identified from the tumour registry. Cases were then linked to radiotherapy records which included dose and modality (external beam radiotherapy and brachytherapy). The pathology reports in the tumour registry were reviewed for pathologic stage, grade and margin status. Results: We identified 9223 patients with prostate cancer. Overall, 36.3% of patients treated with RP had positive margins, and may have benefited from adjuvant radiotherapy. After RP, 332 (15%) patients had radiotherapy to the prostate bed; of these, only 25 (1.1%) received truly adjuvant radiotherapy (delivered within 6 months with a prostate-specific antigen of <0.2 ng/mL). Of the 2181 patients treated with RP, 270 (12%) were seen by a radiation oncologist within 6 months of RP. Of the 1015 patients (47%) with adverse RP pathology (positive margins, extracapsular extension or seminal vesicle invasion), 230 (23%) were seen by a radiation oncologist within 6 months of RP. Conclusion: Not all patients with adverse prostatectomy pathology were seen by a radiation oncologist post-prostatectomy, and very few received adjuvant radiotherapy despite almost half of them having risk factors for relapse.

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Section: Discussioncontrasting

confidence: 63%

The need for, and utilization of prostate-bed radiotherapy after radical prostatectomy for patients with prostate cancer in British Columbia

Tyldesley

Peacock

Morris

et al. 2012

CUAJ

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“…However, in unilateral NS groups, only 2 cases in Group A and 1 case in Group B showed a SM+ on the same side as the NS. As in the study of Palisaar and colleagues, 12 at the multivariate analysis and including the pathological stage, the NS procedure did not influence SM status.…”

Section: Surgical Margin Rates In Radical Prostatectomysupporting

confidence: 48%

“…12 In the recent study of Palisaar and colleagues, 12 in pT2 cancers, the incidence of SM+ did not differ significantly in NS versus no NS cases, whereas in pT3 cases SM+ rate was higher in NS than in no NS procedures. Therefore, Palisaar and colleagues 12 reported that the NS technique is associated with SM+ results, dependent on the pathological stage of the tumour. In our experience, the anterograde or retrograde approach did not modify the impact of NS technique on SM status.…”

Section: Surgical Margin Rates In Radical Prostatectomymentioning

confidence: 89%

“…Cancer was considered organ-confined as long as the capsule was not penetrated, and a surgical margin was considered positive when neoplastic cells reached the inked surface. [11][12][13] As in previous studies 12 the location of SM+ was classified in the apex, the lateral and in other locations (anterior, posterior, bladder neck). We also subdivided margin status into negative (-), solitary positive (+) and multiple positive (++), as is performed in previous studies.…”

Section: Pathological Workupmentioning

confidence: 99%

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Randomized trial comparing an anterograde versus a retrograde approach to open radical prostatectomy: results in terms of positive margin rate

Sciarra

Cristini

Heland

et al. 2013

CUAJ

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Objectives: Surgical technique, patient characteristics and method of pathological review may influence surgical margin (SM) status. Positive surgical margin (SM+) rates of 14% to 46% have been reported in different radical retropubic prostatectomy (RRP) series. We evaluated the effect of an anterograde versus retrograde approach to RRP and specifically focused on the incidence of SM+. Results:In Group A, 22% of cases after RRP showed a pT3 tumour and 39% of cases with a Gleason score ≥7 (4+3); in Group B, 20% of cases showed a pT3 tumour and 37% of cases with a Gleason score ≥7 (4+3) (p > 0.10). The incidence of SM+ was 18% in Group A and 14% in Group B (p = 0.0320). In Group A, 22.2% of cases with SM+ had multiple positive margins, whereas no cases in Group B showed multiple SM+. Regarding the localization of SM+, no difference was found between the 2 groups. In the multivariate analysis, only prostate-specific antigen (p = 0.0090 and p = 0.0020, respectively in the 2 groups) and pathological stage (p < 0.0001 in both groups) were significant and independently associated with SM+ occurrence. Conclusion: In our experience, the anterograde approach to open RRP is associated with lower SM+ rates and no risk of multiple SM+ when compared with the retrograde approach. RésuméObjectifs : La technique chirurgicale, les caractéristiques du patient et la méthode d'examen pathologique peuvent tous avoir un impact sur le statut des marges chirurgicales. Des taux de marges chirurgicales positives de 14 à 46 % ont été notés lors de différentes séries de prostatectomies radicales rétropubiennes (PRR). Nous avons évalué l'effet d'un abord antérograde ou rétrograde, plus précisément sur l'incidence des marges chirurgicales positives.

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“…Respecto a la influencia de la preservación de erectores sobre los márgenes positivos, Palisaar y Huland, presentan unos datos que avalan la seguridad oncológica de éste aspecto técnico en la cirugía abierta, siempre y cuando se realice una correcta selección preoperartoria de los pacientes 34 .…”

Section: Márgenes Positivosunclassified

Prostatectomía radical laparoscópica: Revisión de la literatura. Nuestra experiencia

et al. 2006

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Introducción: En éste trabajo, hemos revisado las últimas publicaciones que hacen referencia a la Prostatectomía Radical Laparoscópica (PRL) hasta el 2005 y describimos nuestra serie en éste tipo de cirugía.Material y Métodos: Tras realizar una búsqueda en Internet, consultando revistas de reconocido prestigio, hemos seleccionado los artículos que hacen referencia a ésta técnica, resumiendo la actualidad de la PRL.Además, presentamos nuestra serie. Resultados: Los buenos resultados oncológicos y funcionales obtenidos con la PRL, y la posibilidad de realizar hernioplastias al igual que en cirugía abierta, hacen de la técnica, un servicio de calidad para el paciente.Conclusiones: Los avances de la técnica, como la utilización de la robótica, cámaras de 3 CCD y la experiencia del cirujano, hacen de la PRL una técnica segura y de calidad, lo que nos obliga, en la medida de nuestras posibilidades, a ofrecerla al paciente.Palabras clave: Laparoscopia. Cáncer de próstata. Prostatectomía radical. ABSTRACT ANALYSIS OF A LAPAROSCOPIC RADICAL PROSTATECTOMY PROGRAM WITH 544 CASESIntroduction: This article reviews the latest publications that refer to Laparoscopic Radical Prostatectomy (LRP) up to 2005, and describes our series of patients for this type of surgery.Materials and methods: After a search of the Internet and consulting journals of renowned prestige, we selected articles that refer to this technique and we summarise the latest developments in LRP. We also present our series of patients.Results: In view of the good oncologic and functional results obtained with LRP, and the possibility of performing hernioplasty as in open surgery, this technique provides a high quality service for patients.Conclusions: Due to the advances in the safety and quality of this technique, such as the use of robots, 3 CCD cameras, and the surgeon's experience, LRP should be offered to our patients, if it is within our means.

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Influence of Nerve-Sparing (NS) Procedure during Radical Prostatectomy (RP) on Margin Status and Biochemical Failure

Cited by 102 publications

References 31 publications

The need for, and utilization of prostate-bed radiotherapy after radical prostatectomy for patients with prostate cancer in British Columbia

The need for, and utilization of prostate-bed radiotherapy after radical prostatectomy for patients with prostate cancer in British Columbia

Randomized trial comparing an anterograde versus a retrograde approach to open radical prostatectomy: results in terms of positive margin rate

Prostatectomía radical laparoscópica: Revisión de la literatura. Nuestra experiencia

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