Related Experiment Video
Updated: Apr 19, 2026
12:10
Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
10.1K
Surgical margin length and location affect recurrence rates after robotic prostatectomy
Harveer S Dev1, Peter Wiklund2, Vipul Patel3
1Department of Urology, Cambridge University Hospitals NHS Trust, Cambridge, UK; Cancer Research UK Cambridge Institute, Cambridge, UK.
Urologic Oncology
|December 17, 2014
Summary
Positive surgical margins (PSM) of 3mm or more, or multiple positive margins, increase biochemical recurrence (BCR) risk after robotic prostatectomy. Apical margins pose a higher BCR risk than posterolateral margins.
Area of Science:
- Urology
- Surgical Oncology
- Oncologic Pathology
Background:
- Robotic-assisted radical prostatectomy is standard for localized prostate cancer.
- Treatment failure is defined by biochemical recurrence (BCR).
- Positive surgical margins (PSM) in open prostatectomy predict recurrence; this study examines PSM in robotic procedures.
Purpose of the Study:
- To evaluate the impact of positive surgical margin (PSM) parameters on BCR rates after robotic-assisted laparoscopic radical prostatectomy.
- To compare BCR risk associated with different types and characteristics of PSMs.
Main Methods:
- Analysis of prospectively collected clinicopathological and histopathological data from 4,001 patients with ≥3 years follow-up.
- Utilized Kaplan-Meier plots and three statistical models: crude rates, multivariable Cox regression, and propensity-adjusted Cox regression.
- Investigated the effect of margin length, multifocality, and location (apical, posterolateral, basal) on BCR.
Main Results:
- 37% of patients with PSM experienced BCR versus 10% with negative margins (HR=1.81).
- PSM length ≥3 mm and multifocal positive margins were associated with higher BCR risk.
- Apical margins significantly predicted BCR (HR=2.03) compared to basal margins, while posterolateral margins did not show a significant difference (HR=1.62).
Conclusions:
- A PSM length of ≥3 mm and multiple positive margins predict BCR after robotic prostatectomy.
- Apical positive surgical margins present a greater risk of BCR compared to posterolateral margins, differing from findings in open prostatectomy series.
