Characteristics of positive surgical margins in robotic-assisted radical prostatectomy, open retropubic radical prostatectomy, and laparoscopic radical prostatectomy: A comparative histopathologic study from a single academic center

Roula Albadine, Matthew E. Hyndman, Alcides Chaux, J. Y. Jeong, Shahrazad Saab, Fabio Tavora, Jonathan I. Epstein, Mark L. Gonzalgo, Christian P. Pavlovich, George J. Netto

Research output: Contribution to journalArticle

Abstract

Studies detailing differences in positive surgical margin among open retropubic radical prostatectomy, laparoscopic radical prostatectomy, and robotic-assisted laparoscopic radical prostatectomy are lacking. A retrospective review of all prostatectomies with positive surgical margin performed at our center in 2007 disclosed 99 cases, 6 (5%) of which were reinterpreted cases as having negative margins. Ninety-three cases were, therefore, included, corresponding to 37 retropubic radical prostatectomies, 19 laparoscopic radical prostatectomies, and 37 robotic-assisted laparoscopic radical prostatectomies. The relationship of positive surgical margin characteristics to clinicopathologic parameters and biochemical recurrence was assessed. The most commonly found positive surgical margin site was the apex/distal third in all groups (62% retropubic prostatectomies, 79% laparoscopic prostatectomies, 60% robotic-assisted prostatectomies). Total linear length of positive surgical margin sites was significantly correlated with preoperative prostate-specific antigen, preoperative prostate-specific antigen density, pT stage, and tumor volume (P ≤.001). We found no significant differences among the 3 groups with respect to total linear length, number of foci, laterality, or location of positive surgical margin. The rate of biochemical recurrence was also comparable in the 3 groups. On univariate analyses, biochemical recurrence was significantly associated with preoperative prostate-specific antigen values, preoperative prostate-specific antigen density, Gleason score, number of positive surgical margins, and total linear length of positive surgical margin (P ≤.02). Only preoperative prostate-specific antigen density and number of positive surgical margin foci were statistically significant (P ≤.03) independent predictors of biochemical recurrence. We found no significant difference in positive surgical margin characteristics or biochemical recurrence among the 3 radical prostatectomy modalities. Preoperative prostate-specific antigen density and number of positive surgical margin foci were the only independent predictors of biochemical recurrence.

Original languageEnglish (US)
Pages (from-to)254-260
Number of pages7
JournalHuman pathology
Volume43
Issue number2
DOIs
StatePublished - Feb 1 2012

    Fingerprint

Keywords

  • Biochemical recurrence
  • Laparoscopic prostatectomy
  • Prostate cancer
  • Radical prostatectomy
  • Robotic prostatectomy
  • Surgical margin

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this