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World Journal of Urology
Published in: World Journal of Urology 2/2012

01-04-2012 | Original Article

Surgical margin status of specimen and oncological outcomes after laparoscopic radical prostatectomy: experience after 400 procedures

Authors: Francesco Porpiglia, Cristian Fiori, Matteo Manfredi, Susanna Grande, Massimiliano Poggio, Enrico Bollito, Mauro Papotti, Roberto Mario Scarpa

Published in: World Journal of Urology | Issue 2/2012

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Abstract

Purpose

To analyse the surgical margins status of prostatic glands, resected by laparoscopic radical prostatectomy (LRP) for prostate cancer, and to correlate it with biochemical free survival rate (BFSR).

Methods

Data were collected prospectively from 405 patients undergoing LRP from 2000 to 2009 at a single institution. Patients undergoing neoadjuvant and/or adjuvant therapy were excluded from the study. Three hundred patients matched all the criteria: 232 of these had negative surgical margins (NSM) and 68 positive surgical margins (PSM). The median follow-up was 62 months. PSM were classified based on the following: (a) the number of margins, monofocal and multifocal, (b) the location, apical or non-apical and (c) the extension, ≤2.8 mm or >2.8 mm. These data were then entered into a multivariate analysis.

Results

Overall BFSR rate was 67.6% in PSM group and 88.8% in NSM group (P < 0.001). We registered a HR of 3.78 in multivariate analysis (P < 0.001). In terms of the extension, BFSR in univariate survival analysis was 77.8% in ≤2.8 mm PSM and 38.9% in >2.8 mm PSM (P = 0.003), with a HR of 5.68 (P = 0.011) in multivariate analysis. BFSR was 59% for apical margins and 77% for non-apical margins (P = 0.038). In monofocal margins, BFSR was 73%, while 53% in multifocal (P = 0.014).

Conclusions

We recommend careful evaluation of patients with PSM following LRP, especially if they are more than 2.8 mm, and in these cases, adjuvant therapy should be considered after radical surgery.
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Metadata
Title
Surgical margin status of specimen and oncological outcomes after laparoscopic radical prostatectomy: experience after 400 procedures
Authors
Francesco Porpiglia
Cristian Fiori
Matteo Manfredi
Susanna Grande
Massimiliano Poggio
Enrico Bollito
Mauro Papotti
Roberto Mario Scarpa
Publication date
01-04-2012
Publisher
Springer-Verlag
Published in
World Journal of Urology / Issue 2/2012
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-011-0711-2

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