Anterior prostate fat resection during prostatectomy: a histopathologic review

A common practice during robot-assisted radical prostatectomy (RARP) is to dissect the anterior prostate space and send this anterior fat sample for histological analysis to assess for the presence of any malignant tissue. Theoretically, this may help with prognostication and oncological control, however, is this a futile process? To determine the incidence of malignant tissue found in the anterior prostate (APF) samples sent for histological review. All RARP patients within a single urology centre over a 2-year period were included. The pathology results of these patients were reviewed and the proportion of patients with APF sent were analysed for presence of lymph nodes and malignant tissue. 657 patients were identified. 358 patients had APF samples reviewed by the histopathologists. 38 (10.6%) samples had lymph nodes identified within the sample. Malignant lymph node tissue was found in one patient (0.3%). Given the yield of malignancy found in APF samples is so small and the financial and time burden on pathology services, this process is not worthwhile.