Please use this identifier to cite or link to this item:
http://hdl.handle.net/11434/513
Title: | Predictors of postive surgical margins at open and robot-assited laparocopic radical prostatectomy: a single surgeon series. |
Epworth Authors: | Sengupta, Shomik Ischia, Joseph Webb, David |
Other Authors: | Weerakoon, Mahesha Sethi, Kapil |
Keywords: | Prosatatectomy Positive Surgical Margins Robot Assisted Laparoscopic Radical Prostatecomy RALRP Prostate Cancer Surgical Outcomes Robot Assisted Laparoscopic Radical Prostatectomy ORP Open Radical Prostatectomy Pre-operative Serum PSA Localize Prostate Cancer Biopsy Gleason Score Robotic Radical Prostatectomy Serum PSA |
Issue Date: | Dec-2012 |
Publisher: | Springer |
Citation: | Journal of Robotic Surgery 6.4 (2012): 311-316. |
Abstract: | Robot-assisted laparoscopic radical prostatectomy (RALRP), increasingly used to treat localized prostate cancer, has advantages over open radical prostatectomy (ORP) in terms of reduced bleeding and quicker convalescence. However, debate continues over whether RALRP provides superior or at least equivalent surgical outcomes. This study compares positive surgical margins (+SM), as a surrogate for long-term cancer control, at RALRP and ORP performed by a single experienced surgeon during the process of taking up RALRP. 400 consecutive patients undergoing surgery for prostate cancer under a single surgeon (DW) between November 1999 and July 2009 were studied. Prior to July 2005, all patients underwent ORP; after this date, most patients were treated by RALRP. Data were collected by retrospective chart review and analysed independently of the treating surgeon. +SM were defined as the presence of cancer at an inked surface. Overall, 23 (11.5%) of 200 patients undergoing RALRP had +SM, compared to 40 (20.0%) of 200 patients undergoing ORP (P < 0.05). On univariate logistic regression analysis, in addition to surgical approach (odds ratio [OR] = 1.92), patient age (OR = 1.05), pathologic stage (OR = 3.93) and specimen Gleason (GS) score (OR = 1.86) were significant predictors of +SM. On multivariate analysis, surgical approach, p-stage and specimen GS remained significant predictors of +SM. RALRP is associated with lower rates of +SM compared to ORP, even after adjusting for other known risk factors. Of note, the RALRP in this study were part of the surgeon’s learning curve |
URI: | http://hdl.handle.net/11434/513 |
DOI: | 10.1007/s11701-011-0313-4 |
ISSN: | 1863-2483 1863-2491 |
Journal Title: | Journal of Robotic Surgery |
Type: | Journal Article |
Affiliated Organisations: | Department of Biochemistry, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka; Post Graduate Institute of Science, University of Peradeniya, Peradeniya, Sri Lanka. Division of Anatomic Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA Department of Urology, Austin Health, Victoria, Australia |
Type of Clinical Study or Trial: | Retrospective studies |
Appears in Collections: | Epworth Prostate Centre |
Files in This Item:
There are no files associated with this item.
Items in Epworth are protected by copyright, with all rights reserved, unless otherwise indicated.