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Robotic-assisted laparoscopic and radical retropubic prostatectomy generate similar positive margin rates in low and intermediate risk patients.
Urol Oncol. 2009 Sep-Oct; 27(5):529-33.UO

Abstract

OBJECTIVE

Robotic-assisted laparoscopic prostatectomy (RALP) is being increasingly utilized. To assess the efficacy of the operation, we compared apical and overall margin status for RALP with radical retropubic prostatectomy (RRP) in a group of contemporary patients.

PATIENTS AND METHODS

We retrospectively reviewed 98 consecutive RRPs and then 94 RALPs from a single institution. Groups were analyzed and matched with regard to preoperative prostate-specific antigen (PSA), cancer grade, pathologic stage, and tumor volume. Surgical margins were quantitated.

RESULTS

Clinicopathologic parameters were compared and additional high risk patients were observed in the RRP vs. RALP group. To risk-adjust these patient groups, those meeting preoperative high risk criteria were excluded from further positive margin analysis. Postoperatively, the average tumor volume was 13% in both groups. Pathologic stage pT3 was similar between RRP (14%) and RALP (11%). A positive surgical margin (PSM) was found in 12 cases (14%) after RRP and 11 cases (13%) after RALP including apical margins. Positive margins at the apex, non-apex, and both were statistically similar between groups.

CONCLUSIONS

In this study, no differences were seen between robotic prostatectomy with regard to apical or overall margin status compared with open prostatectomy in lower risk patients. This suggests that despite improved visualization, RALP generates a similar margin status as RRP.

Authors+Show Affiliations

Division of Urology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI 53972, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18640061

Citation

Laurila, Timo A J., et al. "Robotic-assisted Laparoscopic and Radical Retropubic Prostatectomy Generate Similar Positive Margin Rates in Low and Intermediate Risk Patients." Urologic Oncology, vol. 27, no. 5, 2009, pp. 529-33.
Laurila TA, Huang W, Jarrard DF. Robotic-assisted laparoscopic and radical retropubic prostatectomy generate similar positive margin rates in low and intermediate risk patients. Urol Oncol. 2009;27(5):529-33.
Laurila, T. A., Huang, W., & Jarrard, D. F. (2009). Robotic-assisted laparoscopic and radical retropubic prostatectomy generate similar positive margin rates in low and intermediate risk patients. Urologic Oncology, 27(5), 529-33. https://doi.org/10.1016/j.urolonc.2008.05.001
Laurila TA, Huang W, Jarrard DF. Robotic-assisted Laparoscopic and Radical Retropubic Prostatectomy Generate Similar Positive Margin Rates in Low and Intermediate Risk Patients. Urol Oncol. 2009 Sep-Oct;27(5):529-33. PubMed PMID: 18640061.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Robotic-assisted laparoscopic and radical retropubic prostatectomy generate similar positive margin rates in low and intermediate risk patients. AU - Laurila,Timo A J, AU - Huang,Wei, AU - Jarrard,David F, Y1 - 2008/07/21/ PY - 2008/03/18/received PY - 2008/05/02/revised PY - 2008/05/08/accepted PY - 2008/7/22/pubmed PY - 2009/11/18/medline PY - 2008/7/22/entrez SP - 529 EP - 33 JF - Urologic oncology JO - Urol Oncol VL - 27 IS - 5 N2 - OBJECTIVE: Robotic-assisted laparoscopic prostatectomy (RALP) is being increasingly utilized. To assess the efficacy of the operation, we compared apical and overall margin status for RALP with radical retropubic prostatectomy (RRP) in a group of contemporary patients. PATIENTS AND METHODS: We retrospectively reviewed 98 consecutive RRPs and then 94 RALPs from a single institution. Groups were analyzed and matched with regard to preoperative prostate-specific antigen (PSA), cancer grade, pathologic stage, and tumor volume. Surgical margins were quantitated. RESULTS: Clinicopathologic parameters were compared and additional high risk patients were observed in the RRP vs. RALP group. To risk-adjust these patient groups, those meeting preoperative high risk criteria were excluded from further positive margin analysis. Postoperatively, the average tumor volume was 13% in both groups. Pathologic stage pT3 was similar between RRP (14%) and RALP (11%). A positive surgical margin (PSM) was found in 12 cases (14%) after RRP and 11 cases (13%) after RALP including apical margins. Positive margins at the apex, non-apex, and both were statistically similar between groups. CONCLUSIONS: In this study, no differences were seen between robotic prostatectomy with regard to apical or overall margin status compared with open prostatectomy in lower risk patients. This suggests that despite improved visualization, RALP generates a similar margin status as RRP. SN - 1873-2496 UR - https://www.unboundmedicine.com/medline/citation/18640061/Robotic_assisted_laparoscopic_and_radical_retropubic_prostatectomy_generate_similar_positive_margin_rates_in_low_and_intermediate_risk_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1078-1439(08)00119-1 DB - PRIME DP - Unbound Medicine ER -