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Anterior prostate fat resection during prostatectomy: a histopathologic review
A M Guy1, L E Kavanagh2, E Hart2
1Stokes Department of Urology, Royal Surrey Hospital NHS Foundation Trust, Egerton Road, Guildford, Surrey, GU2 7XX, UK. alexandra.guy@nhs.net.
Journal of Robotic Surgery
|November 18, 2020
Summary
Dissecting anterior prostate fat during robot-assisted radical prostatectomy (RARP) rarely identifies malignant tissue. This analysis of anterior prostate fat (APF) samples shows a low yield, suggesting the practice is not worthwhile.
Area of Science:
- Urology
- Surgical Oncology
- Pathology
Background:
- Robot-assisted radical prostatectomy (RARP) involves dissecting anterior prostate fat (APF) for histological analysis.
- Theoretically, APF analysis aids prognostication and oncological control in prostate cancer.
- The clinical utility and yield of this practice remain questionable.
Purpose of the Study:
- To determine the incidence of malignant tissue in APF samples.
- To evaluate the necessity of routine APF histological analysis in RARP.
Main Methods:
- Retrospective review of RARP patients over a 2-year period.
- Analysis of pathology results for APF samples sent for histological review.
- Assessment for the presence of lymph nodes and malignant tissue within APF samples.
Main Results:
- 358 out of 657 RARP patients had APF samples reviewed.
- Lymph nodes were identified in 10.6% of APF samples.
- Malignant lymph node tissue was found in only 0.3% of cases.
Conclusions:
- The incidence of malignancy found in APF samples is very low.
- Routine histological analysis of APF samples represents a significant burden on pathology services.
- The low yield suggests that dissecting and analyzing APF during RARP is not a worthwhile practice.
