Predictors of Positive Surgical Margins After Laparoscopic Robot Assisted Radical Prostatectomy

Ficarra, Vincenzo; Novara, Giacomo; Secco, Silvia; D’Elia, Carolina; Boscolo‐Berto, Rafael; Gardiman, Marina Paola; Cavalleri, Stefano; Artibani, Walter

doi:10.1016/j.juro.2009.08.037

Cited by 69 publications

(52 citation statements)

References 19 publications

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“…Coelho et al [8] reported that only clinical stage is predictive of surgical margin positivity (OR: 10.7; p<0.0002). Ficarra et al [9] also reported that clinical stage was an independent predictive factor for surgical margin positivity (HR: 2.2; p<0.008). However in a study performed by Liss et al [10] the authors empasized that only PSA levels among preoperative factors are influential on surgical margin.…”

Section: Discussionmentioning

confidence: 91%

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Predictive preoperative factors of positivesurgical margins after robotic radical prostatectomy in low-risk prostate cancer

Turan

Boylu

Başataç

et al. 2013

Turkish Journal of Urology

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Objective: Positive surgical margins after radical prostatectomy for localized prostate cancer is a powerful predictor of PSA recurrence. Clinical stage, Gleason score and preoperative PSA are predictive factors for positive surgical margin after radical prostatectomy. In this study, we aimed to identify preoperative factors affecting surgical margin positivity in low-risk prostate cancer after robotic radical prostatectomy (RARP). Material and methods:Between 2008 and 2011 (

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Section: Discussionmentioning

confidence: 91%

“…In a study by Ficarra et al [9] , prostate volume (HR=0.42 (CI 95%: 0.24-0.73; p=0.002), and clinical stage were reported as independent predictive factors for surgical margin positivity. Link et al [18] and Marchetti et al [19] indicated decrease in prostate volume as an independent predictive factor for surgical margin positivity.…”

Section: Discussionmentioning

confidence: 94%

Predictive preoperative factors of positivesurgical margins after robotic radical prostatectomy in low-risk prostate cancer

Turan

Boylu

Başataç

et al. 2013

Turkish Journal of Urology

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“…Likewise in our study, the highest BF rate was observed in pT3a patients as expected. Ficarra et al [9] demonstrated that PSM is strongly associated with pT stage. On the other hand, in their series of 4,490 patients, Budaus et al [10] identified PSA, pT stage, lymph node status, Gleason score and PSM as independent prognostic factors for BF after RP.…”

Section: Discussionmentioning

confidence: 99%

“…Higher postoperative failure rates and worse prognosis are expected in patients with extraprostatic disease and PSMs [2] . Probability of a PSM strongly correlates with stage [9] . PSM acts as an independent prognostic factor for BF after RP, either alone or when analyzed in pairs with pathological stage, lymph node involvement and Gleason score [10,11] .…”

Section: Introductionmentioning

confidence: 93%

Stage-by-Stage Effects of Surgical Margin Status on Biochemical Failure after Radical Prostatectomy in Patients with Clinically Localized Prostate Cancer

Akdemir

Özden²,

Öztekin³

et al. 2011

Urol Int

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Purpose: To evaluate the effects of pathological stage and surgical margin status on biochemical failure rates after radical prostatectomy (RP). Materials and Methods: The records of 205 patients who underwent RP for clinically localized prostate cancer (CaP) were evaluated. Known risk factors for biochemical failure (BF) were analyzed using univariate and multivariate logistic regression analysis. The effects of surgical margin status together with pathological stage on BF were evaluated. p values lower than 0.05 were accepted to be statistically significant. Results: Pathological stage, positive surgical margin (PSM), seminal vesicle invasion, lymph node involvement, biopsy Gleason score and postoperative Gleason score were the factors associated with BF in univariate analysis. Logistic regression analysis revealed that pT3a patients with PSM had a significant BF rate when compared to pT2 patients with a negative surgical margin (NSM) (OR 7.46, p = 0.002). pT3a patients with a NSM had a similar BF rate to that of pT2 patients with PSM. Conclusions: pT2 patients with PSM had a similar biochemical prognosis to that of pT3a patients without PSM, implicating that a PSM may have a negative effect on prognosis similar to that of extracapsular invasion.

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“…En nuestra experiencia la IPN se comporta como factor pronóstico de márgenes afectos y de EEP. Ficarra et al 29 y Bastacky et al 30 consideran IPN marcador de márgenes y de EEP, respectivamente. Parece asumido también que la IPN en pacientes de bajo riesgo aumenta la recidiva bioquímica a los 5 años, no estando claro su papel pronóstico independiente en los de riesgo intermedio o alto 10 .…”

Section: Discussionunclassified

El papel pronóstico de la invasión perineural en la biopsia prostática

et al. 2011

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PALABRAS CLAVECáncer de próstata; Invasión perineural; Extensión extraprostática; Biopsia de próstata; Prostatectomía radical; Pronóstico ResumenIntroducción: A pesar de que la diseminación celular tumoral a través del sistema nervioso intraprostático se considera un mecanismo de progresión del cáncer prostático, el significado de la invasión perineural en biopsias de próstata para predecir extensión extraprostática y su utilidad como potencial factor pronóstico es controvertido. Material y métodos: Estudio retrospectivo llevado a cabo en una institución sobre 208 pacientes tratados con prostatectomía radical (enero 2007-julio 2010) en los que se ha determinado la presencia de invasión perineural y el score de gleason en la biopsia preoperatoria, así como el estadio clínico y el PSA prequirúrgico. Clasificamos los pacientes en grupos de riesgo según la clasificación de D'Amico. Realizamos análisis estadístico bivariante y multivariante para establecer la correlación entre las distintas variables. Resultados: Se objetivó IPN en el 18,3% de las biopsias prostáticas. Presentaron extensión extraprostática el 71% de los espécimenes de prostatectomía con invasión perineural en la biopsia previa vs. 23,1% cuando no existía este hallazgo (p < 0,0001) y márgenes positivos el 47,4% de los casos con IPN, frente a 18,3% sin invasión perineural (p < 0,0001). De hecho, en el análi-sis multivariante la invasión perineural demostró ser un factor de riesgo independiente para presentar extensión extraprostática y márgenes positivos en la pieza de prostatectomía. Conclusiones: La presencia de Invasión perineural es un factor pronóstico útil para la predicción de extensión extraprostática y afectación de márgenes quirúrgicos en la pieza de prostatectomía radical. Consideramos que su determinación puede ser una herramienta útil en la mejora del diagnóstico preoperatorio y en la planificación del tratamiento.

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Predictors of Positive Surgical Margins After Laparoscopic Robot Assisted Radical Prostatectomy

Abstract: Pathological extension of the primary tumor was the most relevant predictor of positive surgical margins. In patients with organ confined disease the presence of perineural invasion was significantly associated with positive surgical margins.

Cited by 69 publications

References 19 publications

Predictive preoperative factors of positivesurgical margins after robotic radical prostatectomy in low-risk prostate cancer

Predictive preoperative factors of positivesurgical margins after robotic radical prostatectomy in low-risk prostate cancer

Stage-by-Stage Effects of Surgical Margin Status on Biochemical Failure after Radical Prostatectomy in Patients with Clinically Localized Prostate Cancer

El papel pronóstico de la invasión perineural en la biopsia prostática

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