342 329

Cited 3 times in

Number of positive preoperative biopsy cores is a predictor of positive surgical margins (PSM) in small prostates after robot-assisted radical prostatectomy (RARP)

Authors
 Patrick H. Tuliao  ;  Kyo C. Koo  ;  Koon H. Rha  ;  Sung J. Hong  ;  Byung H. Chung  ;  Young D. Choi  ;  Chien H. Chang  ;  Christos Komninos 
Citation
 BJU INTERNATIONAL, Vol.116(6) : 897-904, 2015 
Journal Title
 BJU INTERNATIONAL 
ISSN
 1464-4096 
Issue Date
2015
MeSH
Aged ; Humans ; Male ; Middle Aged ; Organ Size ; Prostate/pathology* ; Prostate/physiology ; Prostatectomy/methods* ; Prostatic Neoplasms/epidemiology ; Prostatic Neoplasms/pathology* ; Prostatic Neoplasms/surgery* ; Retrospective Studies ; Robotic Surgical Procedures/methods*
Keywords
prostate ; prostatectomy ; prostatic neoplasms ; surgical margins
Abstract
OBJECTIVE: To determine the impact of prostate size on positive surgical margin (PSM) rates after robot-assisted radical prostatectomy (RARP) and the preoperative factors associated with PSM. PATIENTS AND METHODS: In all, 1229 men underwent RARP by a single surgeon, from 2005 to August of 2013. Excluded were patients who had transurethral resection of the prostate, neoadjuvant therapy, clinically advanced cancer, and the first 200 performed cases (to reduce the effect of learning curve). Included were 815 patients who were then divided into three prostate size groups: <31 g (group 1), 31-45 g (group 2), >45 g (group 3). Multivariate analysis determined predictors of PSM and biochemical recurrence (BCR). RESULTS: Console time and blood loss increased with increasing prostate size. There were more high-grade tumours in group 1 (group 1 vs group 2 and group 3, 33.9% vs 25.1% and 25.6%, P = 0.003 and P = 0.005). PSM rates were higher in prostates of <45 g with preoperative PSA levels of >20 ng/dL, Gleason score ≥7, T3 tumour, and ≥3 positive biopsy cores. In group 1, preoperative stage T3 [odds ratio (OR) 3.94, P = 0.020] and ≥3 positive biopsy cores (OR 2.52, P = 0.043) were predictive of PSM, while a PSA level of >20 ng/dL predicted the occurrence of BCR (OR 5.34, P = 0.021). No preoperative factors predicted PSM or BCR for groups 2 and 3. CONCLUSION: A preoperative biopsy with ≥3 positive cores in men with small prostates predicts PSM after RARP. In small prostates with PSM, a PSA level of >20 ng/dL is a predictor of BCR. These factors should guide the choice of therapy and indicate the need for closer postoperative follow-up.
Files in This Item:
T201504744.pdf Download
DOI
10.1111/bju.12888
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Kyo Chul(구교철) ORCID logo https://orcid.org/0000-0001-7303-6256
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Chang, Chien Hsiang(장첸샹)
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Komninos, Christos(크리스토스콤니노스)
Tuliao, Patrick(툴리아오패트릭)
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139105
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse