High-risk prostate cancer surgical margins during robot-assisted radical prostatectomy - Abstract

OBJECTIVE: To evaluate the feasibility of robot-assisted radical prostatectomy (RARP) in high risk prostate cancer (HR).

The rate of positive surgical margins (PSM) was compared between anticipated HR cancer according to D'Amico risk classification and discovered postoperative HR cancer.

MATERIALS AND METHODS: A retrospective study was conducted between 2006 and 2013 on patients who underwent RARP. Before surgery, patients were divided according to the D'Amico risk classification. After surgery, HR was defined as pT3a or pT3b, or Gleason score≥8 or positive lymph nodes. The rate of PSM was compared according to the D'Amico risk classification and postoperative HR.

RESULTS: During the study, 485 patients were reviewed. Before surgery, 10 % of cancers were classified as D'Amico 3 (49/485). After surgery, 27.6 % (134/485) were classified as HR. There was a significant difference between the rate of PSM in HR/D'Amico 3 and HR/non D'Amico 3 cancer, respectively 22.9 % and 34.3 % (P< 0.001).

CONCLUSION: The RARP is feasible in HR with an average of 30 % of PSM as in open surgery. However, the accurate assessment of preoperative HR will allow a more adapted dissection and a decrease of rate of PSM. So it is necessary to improve the detection of HR and so to select the most suitable cancer for surgery.

Written by:
Duperron C, Moulin M, Koutlidis N, Mourey E, Cormier L.   Are you the author?
Service d'urologie, hôpital Le Bocage, CHU de Dijon, 14, rue Gaffarel, BP 77908, 21079 Dijon cedex, France.

Reference: Prog Urol. 2015 Mar 7. pii: S1166-7087(15)00041-X.
doi: 10.1016/j.purol.2015.02.003


PubMed Abstract
PMID: 25759079

Article in French.

UroToday.com Prostate Cancer Section

E-Newsletters

Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.

Subscribe