The aim of this study was to investigate whether we could detect positive surgical margins during open and laparoscopic radical prostatectomy by 5-aminolevulinic acid (ALA) photodynamic diagnosis (PDD) and mapping of red fluorescence in human prostate cancer cells.
All 52 patients were diagnosed with prostate cancer by biopsy They had a positive core in the apex or highly suspicious positive margins Open and laparoscopic radical prostatectomy was performed in 18 and 34 cases, respectively One gram of ALA solution was given intraoperatively, orally through a stomach tube An endoscopic PDD system, including a D-Light C, CCU Tricam SLII/3CCD CH Tricam-P PDD, and HOPKINS II Straight Forward Telescope 0°, was used The D-Light C light source was equipped with a band-pass filter The CCU Tricam SLII/3CCD CHTricam-P PDD video camera system was equipped with a long-pass filter The laparoscopy optic component was equipped with a yellow long-pass filter
One of the 52 patients had a red-fluorescent-positive margin of the excised whole prostate and the positive surgical margin was histologically confirmed In the section of excised prostate, we obtained 141 biopsied samples The sensitivity and specificity were 75 0% and 87 3%, respectively
Intraoperative ALA-PDD is feasible However, heat degeneration and length of positive surgical margin have crucial influences on red fluorescence In future, a randomized clinical trial should be carried out
BMC urology 2015 Aug 01*** epublish ***
Hideo Fukuhara, Keiji Inoue, Atsushi Kurabayashi, Mutsuo Furihata, Taro Shuin
Department of Urology, Kochi Medical School, Kohasu, Oko, Nankoku, Kochi, 783-8505, Japan jm-fukuhara@kochi-u ac jp , Department of Urology, Kochi Medical School, Kohasu, Oko, Nankoku, Kochi, 783-8505, Japan keiji@kochi-u ac jp , Department of Pathology, Kochi Medical School, Kohasu, Oko, Nankoku, Kochi, 783-8505, Japan kurabaya@kochi-u ac jp , Department of Pathology, Kochi Medical School, Kohasu, Oko, Nankoku, Kochi, 783-8505, Japan furiham@kochi-u ac jp , Department of Urology, Kochi Medical School, Kohasu, Oko, Nankoku, Kochi, 783-8505, Japan shuint@kochi-u ac jp