To investigate the influence of tumor zonality on positive surgical margin (PSM) after Retzius-sparing robot-assisted radical prostatectomy (RS-RARP).
Consecutive 203 patients with prostate cancer (PCa) who underwent RS-RARP in our center were divided into three cohorts according to the tumor zonal origin described on preoperative magnetic resonance imaging (MRI). Clinical and pathological characteristics were compared between the three groups. Relationship of clinicopathological parameters and PSM after RS-RARP was also evaluated.
The rates of PSM in men with transition zone and mixed tumors were significantly higher than that in patients with peripheral zone tumors (p < 0.01). 42.0% and 40.9% of the positive margins in patients with transition zone and mixed cancers were located at the anterior part of the gland, respectively. On multivariate analysis, transition zone tumor was significantly associated with higher PSM rate after RS-RARP (p < 0.01). Sub-analysis revealed that high risk patients with transition tumor had a higher risk of PSM after RS-RARP (p < 0.01).
Transition zone tumor is an independent risk factor for PSM after RS-RARP. Preoperative identification of transition zone tumor might aid surgical planning with Retzius-sparing technique, especially for high risk patients.
BJU international. 2020 Mar 27 [Epub ahead of print]
Youjian Li, Yao Fu, Weijian Li, Linfeng Xu, Qing Zhang, Jie Gao, Danyan Li, Xiaogong Li, Xuefeng Qiu, Hongqian Guo
Department of Urology, Medical School of Nanjing University, Affiliated Drum Tower hospital, Nanjing, 210008, China., Department of Pathology, Medical School of Nanjing University, Affiliated Drum Tower hospital, Nanjing, 210008, China., Department of Radiology, Medical School of Nanjing University, Affiliated Drum Tower hospital, Nanjing, 210008, China.