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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
Prostate Cancer
Surgical Outcomes
Robot Assisted Laparoscopic Radical Prostatectomy
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
DOI: 10.1007/s11701-011-0313-4
ISSN: 1863-2483
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

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