Role of preoperative magnetic resonance imaging on the surgical outcomes of radical prostatectomy: Does preoperative tumor recognition reduce the positive surgical margin in a specific location? Experience from a Thailand prostate cancer specialized center

Hansomwong, Thitipat; Saksirisampant, Pat; Isharwal, Sudhir; Aussavavirojekul, Pubordee; Woranisarakul, Varat; Jitpraphai, Siros; Leewansangtong, Sunai; Taweemonkongsap, Tawatchai; Srinualnad, Sittiporn

doi:10.1016/j.ajur.2022.05.012

Cited by 2 publications

(1 citation statement)

References 24 publications

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“…Prostate cancer remains a leading health concern, with successful management based on the precision of preoperative assessment. Accurate staging of the disease is a cornerstone for guiding therapeutic decisions and forecasting patient outcomes, necessitating a comprehensive evaluation that includes a detailed analysis of tumor size, location, and potential spread (1,2). The interaction between clinical findings and pathological data plays a fundamental role in shaping the treatment trajectory, influencing both immediate surgical decisions and long-term management strategies (3,4).…”

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confidence: 99%

Correlations Between Preoperative Indicators and Postoperative Histopathological Outcomes in Prostate Cancer Patients

Arıkan,

Taştekin,

Arda

2023

Med Sci Discov

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Objective: Prostate cancer continues to pose a significant health challenge, with diverse prognoses influenced by preoperative and postoperative assessments. This study aims to elucidate the correlation between preoperative clinical indicators and postoperative histopathological outcomes to enhance prognostic models. The primary objective of this study is to investigate the predictive value of preoperative factors, such as age, Prostate-Specific Antigen (PSA) level, prostate volume (PV), and tumor volume (TV), on postoperative outcomes, specifically focusing on extracapsular invasion (ECI), seminal vesicle invasion (SVI), and positive surgical margins (PSM). Materials and Methods: We retrospectively analyzed the data of 63 patients with prostate cancer who underwent radical prostatectomy. Preoperative clinical data, including age, PSA level, PV, and TV, were collected. Postoperative histopathological data were gathered for ECI, SVI, and PSM. Statistical analyses, including correlation coefficients and median comparisons, were employed to identify significant predictors of postoperative outcomes. Results: The cohort had a mean age of 64.1 years, with PSA levels ranging from 3.65 to 112 ng/ml. Patients with ECI had a median PSA of 14.9 ng/ml, whereas those without had 8.2 ng/ml (p=0.001). Median PV and TV were significantly higher in patients with ECI (PV: 55 cc, TV: 8.07 cc) than in those without ECI (PV: 49 cc, TV: 4.25 cc, p=0.001). Similar significant differences were noted for SVI and PSM, with higher PSA, PV, and TV values in patients with these features (p≤0.042). Age did not significantly affect the outcomes. Conclusion: Preoperative PSA level, prostate volume, and tumor volume were significant predictors of adverse postoperative histopathological features in patients with prostate cancer. These findings highlight the need for a multifactorial approach in preoperative evaluation and advocate the development of enhanced predictive models for improved clinical decision-making and patient management.

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Section: Introductionmentioning

confidence: 99%

Correlations Between Preoperative Indicators and Postoperative Histopathological Outcomes in Prostate Cancer Patients

Arıkan,

Taştekin,

Arda

2023

Med Sci Discov

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The Impact of Retro-apical Urethral Dissection Approach Technique on Positive Surgical Margins in Robotic-assisted Laparoscopic Radical Prostatectomy: A Study in Thailand

Mahamongkol,

Hajidae,

Aussavavirojekul

et al. 2023

Siriraj Med J

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Objective: Among the various postoperative outcomes following robotic-assisted laparoscopic radical prostatectomy (RARP), positive surgical margins (PSMs) are a significant prognostic factor associated with biochemical recurrence (BCR). Many surgical techniques are available for RARP; however, the technique proposed in this study may improve surgical outcomes. This study aims to evaluate the incidence of post-operative PSMs in patients diagnosed with clinically localized prostate cancer at Siriraj Hospital using the retro-apical urethral dissection approach with a 30-degree-lens flip-up technique. Materials and Methods: A retrospective review of 2,114 consecutive patients who underwent RARP with the conventional technique was conducted using Siriraj Hospital’s database, from January 2007 to June 2022. Propensity score matching was employed to select a group of 284 men from the total cohort of 2,114 patients who underwent conventional radical prostatectomy (Group 1) for comparison against another group of 284 patients who underwent the retro-apical dissection technique (Group 2). The incidence of PSMs was then evaluated in each group. Results: Of the 568 patients, PSMs were observed in 219 patients. The overall incidence of PSMs decreased from 128 cases (45.1%) in Group 1 to 91 cases (32.0%) in Group 2 (p-value <0.01). Similar results were seen in the subgroup of patients with pT2 staging who had PSMs (52 cases vs 24 cases, p-value <0.01). PSMs occurred mostly at the apex with a total of 112 cases (52.1%). Conclusion: The retro-apical urethral dissection approach with a 30-degree-lens flip-up technique is associated with a lower risk of overall PSMs and the trend of apical PSMs, indicating its clinical significance.

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Role of preoperative magnetic resonance imaging on the surgical outcomes of radical prostatectomy: Does preoperative tumor recognition reduce the positive surgical margin in a specific location? Experience from a Thailand prostate cancer specialized center

Cited by 2 publications

References 24 publications

Correlations Between Preoperative Indicators and Postoperative Histopathological Outcomes in Prostate Cancer Patients

Correlations Between Preoperative Indicators and Postoperative Histopathological Outcomes in Prostate Cancer Patients

The Impact of Retro-apical Urethral Dissection Approach Technique on Positive Surgical Margins in Robotic-assisted Laparoscopic Radical Prostatectomy: A Study in Thailand

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