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Factors affecting surgical margin positivity in robotic assisted radical prostatectomy
Mustafa Yuksel1, Kaan Karamık, Hakan Anıl
1Antalya Training and Research Hospital, Antalya. drmustafayuksel@outlook.com.
Summary
Robotic assisted radical prostatectomy (RALP) shows similar surgical margin positivity rates to retropubic radical prostatectomy (RRP). Factors like positive biopsy cores, advanced pathological stage, and seminal vesicle invasion significantly correlate with positive margins in RALP.
Area of Science:
- Urology
- Surgical Oncology
- Robotic Surgery
Background:
- Surgical margin positivity after radical prostatectomy is a key predictor of biochemical recurrence and disease progression.
- Comparing outcomes between different surgical approaches is crucial for optimizing patient care.
Purpose of the Study:
- To compare surgical margin positivity rates between retropubic radical prostatectomy (RRP) and robotic assisted radical prostatectomy (RALP).
- To identify factors associated with surgical margin positivity specifically in patients undergoing RALP.
Main Methods:
- Retrospective analysis of data from 78 RRP and 62 RALP patients operated between May 2011 and March 2016.
- Comparison of demographic, perioperative, and oncologic parameters between RRP and RALP groups.
- Investigation of correlations between surgical margin status and various clinicopathological factors in the RALP cohort.
Main Results:
- No significant difference in surgical margin positivity was observed between RALP (37.1%) and RRP (29.5%) groups (p = 0.341).
- RALP patients experienced lower postoperative hematocrit reduction and shorter hospital stays (p < 0.001).
- In RALP, surgical margin positivity correlated with positive biopsy core number, pathological stage, Gleason score, EAU risk classification, seminal vesicle invasion, and extraprostatic extension.
Conclusions:
- Robotic assisted radical prostatectomy (RALP) demonstrates comparable surgical margin positivity rates to traditional retropubic radical prostatectomy (RRP).
- Key factors influencing positive surgical margins in RALP include biopsy findings, pathological stage, Gleason score, EAU risk, seminal vesicle invasion, and extraprostatic extension.