Recent studies showed that robot-assisted radical prostatectomy (RARP) represents an oncologically safe procedure in patients with prostate cancer (PCa), where the rate of positive surgical margins (PSMs) might be lower in patients treated with RARP as compared with that of those undergoing the open approach (open RP [ORP]).
The aim of this study is to analyze the rate of PSMs according to preoperative risk groups in a large cohort of patients treated with RARP and ORP in a single institution with standardized surgical technique and pathological examination.
We evaluated 6,194 consecutive patients with PCa undergoing either ORP (71. 1%) or RARP (28. 9%) between 1992 and 2014. Logistic regression analyses were used to test the association between type of surgery and PSMs in each preoperative risk group (low vs. intermediate vs. high) after adjusting for confounders.
Overall, 21. 6% patients had PSMs. RARP was associated with a lower rate of PSMs in low-risk (11. 5 vs. 15. 4%, P = 0. 01), intermediate-risk (18. 9 vs. 23. 5%, P = 0. 008), and high-risk patients (19. 7 vs. 30. 1%, P
The introduction of RARP at our institution led to a significant reduction in the risk of PSMs in patients with PCa with high-risk disease.
Urologic oncology. 2015 Sep 28 [Epub ahead of print]
Nazareno Suardi, Paolo Dell׳Oglio, Andrea Gallina, Giorgio Gandaglia, Nicolò Buffi, Marco Moschini, Nicola Fossati, Giovanni Lughezzani, Pierre I Karakiewicz, Massimo Freschi, Roberta Lucianò, Shahrokh F Shariat, Giorgio Guazzoni, Franco Gaboardi, Francesco Montorsi, Alberto Briganti
Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy. Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada. , Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy. , Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy. , Department of Urology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy. , Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy. , Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy. , Department of Urology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy. , Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Department of Urology, University of Montreal Health Center, Montreal, Canada. , Division of Oncology/Unit of Pathology, IRCCS Ospedale San Raffaele, Milan, Italy. , Division of Oncology/Unit of Pathology, IRCCS Ospedale San Raffaele, Milan, Italy. , Department of Urology, Medical University of Vienna and General Hospital, Vienna, Austria. , Department of Urology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy. , Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy. , Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy. , Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.