A Multinational, Multi-institutional Study Comparing Positive Surgical Margin Rates Among 22 393 Open, Laparoscopic, and Robot-assisted Radical Prostatectomy Patients
Identifieur interne : 000267 ( PascalFrancis/Corpus ); précédent : 000266; suivant : 000268A Multinational, Multi-institutional Study Comparing Positive Surgical Margin Rates Among 22 393 Open, Laparoscopic, and Robot-assisted Radical Prostatectomy Patients
Auteurs : Prasanna Sooriakumaran ; Abhishek Srivastava ; Shahrokh F. Shariat ; Phillip D. Strieker ; Thomas Ahlering ; Christopher G. Eden ; Peter N. Wiklund ; Rafael Sanchez-Salas ; Alexandre Mottrie ; David Lee ; David E. Neal ; Reza Ghavamian ; Peter Nyirady ; Andreas Nilsson ; Stefan Carlsson ; Evanguelos Xylinas ; Wolfgang Loidl ; Christian Seitz ; Paul Schramek ; Claus Roehrborn ; Xavier Cathelineau ; Douglas Skarecky ; Greg Shaw ; Anne Warren ; Warick J. Delprado ; Anne-Marie Haynes ; Ewout Steyerberg ; Monique J. Roobol ; Ashutosh K. TewariSource :
- European urology [ 0302-2838 ] ; 2014.
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English descriptors
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Abstract
Background: Positive surgical margins (PSMs) are a known risk factor for biochemical recurrence in patients with prostate cancer (PCa) and are potentially affected by surgical technique and volume. Objective: To investigate whether radical prostatectomy (RP) modality and volume affect PSM rates. Design, setting, and participants: Fourteen institutions in Europe, the United States, and Australia were invited to participate in this study, all of which retrospectively provided margins data on 9778 open RP, 4918 laparoscopic RP, and 7697 robotic RP patients operated on between January 2000 and October 2011. Outcome measurements and statistical analyses: The outcome measure was PSM rate. Multivariable logistic regression analyses and propensity score methods identified odds ratios for risk of a PSM for one modality compared with another, after adjustment for age, preoperative prostate-specific antigen, postoperative Gleason score, pathologic stage, and year of surgery. Classic adjustment using standard covariates was also implemented to compare PSM rates based on center volume for each minimally invasive surgical cohort. Results and limitations: Open RP patients had higher-risk PCa at time of surgery on average and were operated on earlier in the study time period on average, compared with minimally invasive cohorts. Crude margin rates were lowest for robotic RP (13.8%), intermediate for laparoscopic RP (16.3%), and highest for open RP (22.8%); significant differences persisted, although were ameliorated, after statistical adjustments. Lower-volume centers had increased risks of PSM compared with the highest-volume center for both laparoscopic RP and robotic RP. The study is limited by its nonrandomized nature; missing data across covariates, especially year of surgery in many of the open cohort cases; lack of standardized histologic processing and central pathology review; and lack of information regarding potential confounders such as patient comorbidity, nerve-sparing status, lymph node status, tumor volume, and individual surgeon caseload.
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Format Inist (serveur)
| NO : | PASCAL 14-0223163 INIST |
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| ET : | A Multinational, Multi-institutional Study Comparing Positive Surgical Margin Rates Among 22 393 Open, Laparoscopic, and Robot-assisted Radical Prostatectomy Patients |
| AU : | SOORIAKUMARAN (Prasanna); SRIVASTAVA (Abhishek); SHARIAT (Shahrokh F.); STRIEKER (Phillip D.); AHLERING (Thomas); EDEN (Christopher G.); WIKLUND (Peter N.); SANCHEZ-SALAS (Rafael); MOTTRIE (Alexandre); LEE (David); NEAL (David E.); GHAVAMIAN (Reza); NYIRADY (Peter); NILSSON (Andreas); CARLSSON (Stefan); XYLINAS (Evanguelos); LOIDL (Wolfgang); SEITZ (Christian); SCHRAMEK (Paul); ROEHRBORN (Claus); CATHELINEAU (Xavier); SKARECKY (Douglas); SHAW (Greg); WARREN (Anne); DELPRADO (Warick J.); HAYNES (Anne-Marie); STEYERBERG (Ewout); ROOBOL (Monique J.); TEWARI (Ashutosh K.) |
| AF : | Surgical Intervention Trials Unit, Nuffield Department of Surgical Sciences, University of Oxford/Oxford/Royaume-Uni (1 aut.); Department of Molecular Medicine and Surgery, Karolinska Institutet/Stockholm/Suède (1 aut., 7 aut., 14 aut., 15 aut.); Department of Urology, Montefiore Medical Center/New York, NY/Etats-Unis (2 aut., 12 aut.); Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital/New York, NY/Etats-Unis (3 aut., 16 aut., 29 aut.); Department of Urology, Medical University of Vienna/Vienna/Autriche (3 aut., 18 aut.); Prostate Cancer Centre, St. Vincent's Clinic/Sydney/Australie (4 aut., 25 aut., 26 aut.); Department of Urology, University of California-Irvine School of Medicine/Irvine, CA/Etats-Unis (5 aut., 22 aut.); Department of Urology, Royal Surrey County Hospital/Guildford/Royaume-Uni (6 aut.); Department of Urology, L'Institut Mutualiste Montsouris/Paris/France (8 aut., 21 aut.); Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital/Aalst/Belgique (9 aut.); Department of Urology, University of Pennsylvania/Philadelphia, PA/Etats-Unis (10 aut.); Department of Uro-oncology, University of Cambridge/Cambridge/Royaume-Uni (11 aut.); Uro-oncology Research Group, Cancer Research UK, Cambridge Research Institute/Cambridge/Royaume-Uni (11 aut., 23 aut.); Department of Urology, Semmelweis University/Budapest/Hongrie (13 aut.); Department of Urology, St. Vincent's Hospital/Linz/Autriche (17 aut.); Department of Urology, Saint John of God Hospital/Vienna/Autriche (19 aut.); Department of Urology, University of Texas Southwestern Medical Center/Dallas, TX/Etats-Unis (20 aut.); Department of Histopathology, Cambridge University Hospitals NHS Foundation Trust/Cambridge/Royaume-Uni (24 aut.); Department of Public Health, Erasmus MC-University Medical Center Rotterdam/Rotterdam/Pays-Bas (27 aut., 28 aut.) |
| DT : | Publication en série; Niveau analytique |
| SO : | European urology; ISSN 0302-2838; Coden EUURAV; Royaume-Uni; Da. 2014; Vol. 66; No. 3; Pp. 450-456; Bibl. 27 ref. |
| LA : | Anglais |
| EA : | Background: Positive surgical margins (PSMs) are a known risk factor for biochemical recurrence in patients with prostate cancer (PCa) and are potentially affected by surgical technique and volume. Objective: To investigate whether radical prostatectomy (RP) modality and volume affect PSM rates. Design, setting, and participants: Fourteen institutions in Europe, the United States, and Australia were invited to participate in this study, all of which retrospectively provided margins data on 9778 open RP, 4918 laparoscopic RP, and 7697 robotic RP patients operated on between January 2000 and October 2011. Outcome measurements and statistical analyses: The outcome measure was PSM rate. Multivariable logistic regression analyses and propensity score methods identified odds ratios for risk of a PSM for one modality compared with another, after adjustment for age, preoperative prostate-specific antigen, postoperative Gleason score, pathologic stage, and year of surgery. Classic adjustment using standard covariates was also implemented to compare PSM rates based on center volume for each minimally invasive surgical cohort. Results and limitations: Open RP patients had higher-risk PCa at time of surgery on average and were operated on earlier in the study time period on average, compared with minimally invasive cohorts. Crude margin rates were lowest for robotic RP (13.8%), intermediate for laparoscopic RP (16.3%), and highest for open RP (22.8%); significant differences persisted, although were ameliorated, after statistical adjustments. Lower-volume centers had increased risks of PSM compared with the highest-volume center for both laparoscopic RP and robotic RP. The study is limited by its nonrandomized nature; missing data across covariates, especially year of surgery in many of the open cohort cases; lack of standardized histologic processing and central pathology review; and lack of information regarding potential confounders such as patient comorbidity, nerve-sparing status, lymph node status, tumor volume, and individual surgeon caseload. |
| CC : | 002B14 |
| FD : | Marge chirurgicale; Etude comparative; Chirurgie endoscopique; Taux; Prostatectomie; Coeliochirurgie; Robotique; Homme; Laparoscopie; Télémédecine; Néphrologie; Urologie; Traitement |
| FG : | Endoscopie |
| ED : | Surgical margin; Comparative study; Endoscopic surgery; Rate; Prostatectomy; Laparoscopic surgery; Robotics; Human; Laparoscopy; Telemedicine; Nephrology; Urology; Treatment |
| EG : | Endoscopy |
| SD : | Margen quirúrgica; Estudio comparativo; Cirugía endoscópica; Tasa; Prostatectomía; Cirugía laparoscopica; Robótica; Hombre; Laparoscopia; Telemedicina; Nefrología; Urología; Tratamiento |
| LO : | INIST-16847.354000504835110130 |
| ID : | 14-0223163 |
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Pascal:14-0223163Le document en format XML
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Eden</name><affiliation><inist:fA14 i1="08"><s1>Department of Urology, Royal Surrey County Hospital</s1><s2>Guildford</s2><s3>GBR</s3><sZ>6 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Wiklund, Peter N" sort="Wiklund, Peter N" uniqKey="Wiklund P" first="Peter N." last="Wiklund">Peter N. Wiklund</name><affiliation><inist:fA14 i1="02"><s1>Department of Molecular Medicine and Surgery, Karolinska Institutet</s1><s2>Stockholm</s2><s3>SWE</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Sanchez Salas, Rafael" sort="Sanchez Salas, Rafael" uniqKey="Sanchez Salas R" first="Rafael" last="Sanchez-Salas">Rafael Sanchez-Salas</name><affiliation><inist:fA14 i1="09"><s1>Department of Urology, L'Institut Mutualiste Montsouris</s1><s2>Paris</s2><s3>FRA</s3><sZ>8 aut.</sZ><sZ>21 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Mottrie, Alexandre" sort="Mottrie, Alexandre" uniqKey="Mottrie A" first="Alexandre" last="Mottrie">Alexandre Mottrie</name><affiliation><inist:fA14 i1="10"><s1>Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital</s1><s2>Aalst</s2><s3>BEL</s3><sZ>9 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Lee, David" sort="Lee, David" uniqKey="Lee D" first="David" last="Lee">David Lee</name><affiliation><inist:fA14 i1="11"><s1>Department of Urology, University of Pennsylvania</s1><s2>Philadelphia, PA</s2><s3>USA</s3><sZ>10 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Neal, David E" sort="Neal, David E" uniqKey="Neal D" first="David E." last="Neal">David E. Neal</name><affiliation><inist:fA14 i1="12"><s1>Department of Uro-oncology, University of Cambridge</s1><s2>Cambridge</s2><s3>GBR</s3><sZ>11 aut.</sZ></inist:fA14></affiliation><affiliation><inist:fA14 i1="13"><s1>Uro-oncology Research Group, Cancer Research UK, Cambridge Research Institute</s1><s2>Cambridge</s2><s3>GBR</s3><sZ>11 aut.</sZ><sZ>23 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Ghavamian, Reza" sort="Ghavamian, Reza" uniqKey="Ghavamian R" first="Reza" last="Ghavamian">Reza Ghavamian</name><affiliation><inist:fA14 i1="03"><s1>Department of Urology, Montefiore Medical Center</s1><s2>New York, NY</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>12 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Nyirady, Peter" sort="Nyirady, Peter" uniqKey="Nyirady P" first="Peter" last="Nyirady">Peter Nyirady</name><affiliation><inist:fA14 i1="14"><s1>Department of Urology, Semmelweis University</s1><s2>Budapest</s2><s3>HUN</s3><sZ>13 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Nilsson, Andreas" sort="Nilsson, Andreas" uniqKey="Nilsson A" first="Andreas" last="Nilsson">Andreas Nilsson</name><affiliation><inist:fA14 i1="02"><s1>Department of Molecular Medicine and Surgery, Karolinska Institutet</s1><s2>Stockholm</s2><s3>SWE</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Carlsson, Stefan" sort="Carlsson, Stefan" uniqKey="Carlsson S" first="Stefan" last="Carlsson">Stefan Carlsson</name><affiliation><inist:fA14 i1="02"><s1>Department of Molecular Medicine and Surgery, Karolinska Institutet</s1><s2>Stockholm</s2><s3>SWE</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Xylinas, Evanguelos" sort="Xylinas, Evanguelos" uniqKey="Xylinas E" first="Evanguelos" last="Xylinas">Evanguelos Xylinas</name><affiliation><inist:fA14 i1="04"><s1>Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital</s1><s2>New York, NY</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>16 aut.</sZ><sZ>29 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Loidl, Wolfgang" sort="Loidl, Wolfgang" uniqKey="Loidl W" first="Wolfgang" last="Loidl">Wolfgang Loidl</name><affiliation><inist:fA14 i1="15"><s1>Department of Urology, St. Vincent's Hospital</s1><s2>Linz</s2><s3>AUT</s3><sZ>17 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Seitz, Christian" sort="Seitz, Christian" uniqKey="Seitz C" first="Christian" last="Seitz">Christian Seitz</name><affiliation><inist:fA14 i1="05"><s1>Department of Urology, Medical University of Vienna</s1><s2>Vienna</s2><s3>AUT</s3><sZ>3 aut.</sZ><sZ>18 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Schramek, Paul" sort="Schramek, Paul" uniqKey="Schramek P" first="Paul" last="Schramek">Paul Schramek</name><affiliation><inist:fA14 i1="16"><s1>Department of Urology, Saint John of God Hospital</s1><s2>Vienna</s2><s3>AUT</s3><sZ>19 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Roehrborn, Claus" sort="Roehrborn, Claus" uniqKey="Roehrborn C" first="Claus" last="Roehrborn">Claus Roehrborn</name><affiliation><inist:fA14 i1="17"><s1>Department of Urology, University of Texas Southwestern Medical Center</s1><s2>Dallas, TX</s2><s3>USA</s3><sZ>20 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Cathelineau, Xavier" sort="Cathelineau, Xavier" uniqKey="Cathelineau X" first="Xavier" last="Cathelineau">Xavier Cathelineau</name><affiliation><inist:fA14 i1="09"><s1>Department of Urology, L'Institut Mutualiste Montsouris</s1><s2>Paris</s2><s3>FRA</s3><sZ>8 aut.</sZ><sZ>21 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Skarecky, Douglas" sort="Skarecky, Douglas" uniqKey="Skarecky D" first="Douglas" last="Skarecky">Douglas Skarecky</name><affiliation><inist:fA14 i1="07"><s1>Department of Urology, University of California-Irvine School of Medicine</s1><s2>Irvine, CA</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>22 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Shaw, Greg" sort="Shaw, Greg" uniqKey="Shaw G" first="Greg" last="Shaw">Greg Shaw</name><affiliation><inist:fA14 i1="13"><s1>Uro-oncology Research Group, Cancer Research UK, Cambridge Research Institute</s1><s2>Cambridge</s2><s3>GBR</s3><sZ>11 aut.</sZ><sZ>23 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Warren, Anne" sort="Warren, Anne" uniqKey="Warren A" first="Anne" last="Warren">Anne Warren</name><affiliation><inist:fA14 i1="18"><s1>Department of Histopathology, Cambridge University Hospitals NHS Foundation Trust</s1><s2>Cambridge</s2><s3>GBR</s3><sZ>24 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Delprado, Warick J" sort="Delprado, Warick J" uniqKey="Delprado W" first="Warick J." last="Delprado">Warick J. Delprado</name><affiliation><inist:fA14 i1="06"><s1>Prostate Cancer Centre, St. Vincent's Clinic</s1><s2>Sydney</s2><s3>AUS</s3><sZ>4 aut.</sZ><sZ>25 aut.</sZ><sZ>26 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Haynes, Anne Marie" sort="Haynes, Anne Marie" uniqKey="Haynes A" first="Anne-Marie" last="Haynes">Anne-Marie Haynes</name><affiliation><inist:fA14 i1="06"><s1>Prostate Cancer Centre, St. Vincent's Clinic</s1><s2>Sydney</s2><s3>AUS</s3><sZ>4 aut.</sZ><sZ>25 aut.</sZ><sZ>26 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Steyerberg, Ewout" sort="Steyerberg, Ewout" uniqKey="Steyerberg E" first="Ewout" last="Steyerberg">Ewout Steyerberg</name><affiliation><inist:fA14 i1="19"><s1>Department of Public Health, Erasmus MC-University Medical Center Rotterdam</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>27 aut.</sZ><sZ>28 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Roobol, Monique J" sort="Roobol, Monique J" uniqKey="Roobol M" first="Monique J." last="Roobol">Monique J. Roobol</name><affiliation><inist:fA14 i1="19"><s1>Department of Public Health, Erasmus MC-University Medical Center Rotterdam</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>27 aut.</sZ><sZ>28 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Tewari, Ashutosh K" sort="Tewari, Ashutosh K" uniqKey="Tewari A" first="Ashutosh K." last="Tewari">Ashutosh K. Tewari</name><affiliation><inist:fA14 i1="04"><s1>Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital</s1><s2>New York, NY</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>16 aut.</sZ><sZ>29 aut.</sZ></inist:fA14></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">14-0223163</idno><date when="2014">2014</date><idno type="stanalyst">PASCAL 14-0223163 INIST</idno><idno type="RBID">Pascal:14-0223163</idno><idno type="wicri:Area/PascalFrancis/Corpus">000267</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">A Multinational, Multi-institutional Study Comparing Positive Surgical Margin Rates Among 22 393 Open, Laparoscopic, and Robot-assisted Radical Prostatectomy Patients</title><author><name sortKey="Sooriakumaran, Prasanna" sort="Sooriakumaran, Prasanna" uniqKey="Sooriakumaran P" first="Prasanna" last="Sooriakumaran">Prasanna Sooriakumaran</name><affiliation><inist:fA14 i1="01"><s1>Surgical Intervention Trials Unit, Nuffield Department of Surgical Sciences, University of Oxford</s1><s2>Oxford</s2><s3>GBR</s3><sZ>1 aut.</sZ></inist:fA14></affiliation><affiliation><inist:fA14 i1="02"><s1>Department of Molecular Medicine and Surgery, Karolinska Institutet</s1><s2>Stockholm</s2><s3>SWE</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Srivastava, Abhishek" sort="Srivastava, Abhishek" uniqKey="Srivastava A" first="Abhishek" last="Srivastava">Abhishek Srivastava</name><affiliation><inist:fA14 i1="03"><s1>Department of Urology, Montefiore Medical Center</s1><s2>New York, NY</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>12 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Shariat, Shahrokh F" sort="Shariat, Shahrokh F" uniqKey="Shariat S" first="Shahrokh F." last="Shariat">Shahrokh F. Shariat</name><affiliation><inist:fA14 i1="04"><s1>Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital</s1><s2>New York, NY</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>16 aut.</sZ><sZ>29 aut.</sZ></inist:fA14></affiliation><affiliation><inist:fA14 i1="05"><s1>Department of Urology, Medical University of Vienna</s1><s2>Vienna</s2><s3>AUT</s3><sZ>3 aut.</sZ><sZ>18 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Strieker, Phillip D" sort="Strieker, Phillip D" uniqKey="Strieker P" first="Phillip D." last="Strieker">Phillip D. Strieker</name><affiliation><inist:fA14 i1="06"><s1>Prostate Cancer Centre, St. Vincent's Clinic</s1><s2>Sydney</s2><s3>AUS</s3><sZ>4 aut.</sZ><sZ>25 aut.</sZ><sZ>26 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Ahlering, Thomas" sort="Ahlering, Thomas" uniqKey="Ahlering T" first="Thomas" last="Ahlering">Thomas Ahlering</name><affiliation><inist:fA14 i1="07"><s1>Department of Urology, University of California-Irvine School of Medicine</s1><s2>Irvine, CA</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>22 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Eden, Christopher G" sort="Eden, Christopher G" uniqKey="Eden C" first="Christopher G." last="Eden">Christopher G. Eden</name><affiliation><inist:fA14 i1="08"><s1>Department of Urology, Royal Surrey County Hospital</s1><s2>Guildford</s2><s3>GBR</s3><sZ>6 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Wiklund, Peter N" sort="Wiklund, Peter N" uniqKey="Wiklund P" first="Peter N." last="Wiklund">Peter N. Wiklund</name><affiliation><inist:fA14 i1="02"><s1>Department of Molecular Medicine and Surgery, Karolinska Institutet</s1><s2>Stockholm</s2><s3>SWE</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Sanchez Salas, Rafael" sort="Sanchez Salas, Rafael" uniqKey="Sanchez Salas R" first="Rafael" last="Sanchez-Salas">Rafael Sanchez-Salas</name><affiliation><inist:fA14 i1="09"><s1>Department of Urology, L'Institut Mutualiste Montsouris</s1><s2>Paris</s2><s3>FRA</s3><sZ>8 aut.</sZ><sZ>21 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Mottrie, Alexandre" sort="Mottrie, Alexandre" uniqKey="Mottrie A" first="Alexandre" last="Mottrie">Alexandre Mottrie</name><affiliation><inist:fA14 i1="10"><s1>Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital</s1><s2>Aalst</s2><s3>BEL</s3><sZ>9 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Lee, David" sort="Lee, David" uniqKey="Lee D" first="David" last="Lee">David Lee</name><affiliation><inist:fA14 i1="11"><s1>Department of Urology, University of Pennsylvania</s1><s2>Philadelphia, PA</s2><s3>USA</s3><sZ>10 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Neal, David E" sort="Neal, David E" uniqKey="Neal D" first="David E." last="Neal">David E. Neal</name><affiliation><inist:fA14 i1="12"><s1>Department of Uro-oncology, University of Cambridge</s1><s2>Cambridge</s2><s3>GBR</s3><sZ>11 aut.</sZ></inist:fA14></affiliation><affiliation><inist:fA14 i1="13"><s1>Uro-oncology Research Group, Cancer Research UK, Cambridge Research Institute</s1><s2>Cambridge</s2><s3>GBR</s3><sZ>11 aut.</sZ><sZ>23 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Ghavamian, Reza" sort="Ghavamian, Reza" uniqKey="Ghavamian R" first="Reza" last="Ghavamian">Reza Ghavamian</name><affiliation><inist:fA14 i1="03"><s1>Department of Urology, Montefiore Medical Center</s1><s2>New York, NY</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>12 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Nyirady, Peter" sort="Nyirady, Peter" uniqKey="Nyirady P" first="Peter" last="Nyirady">Peter Nyirady</name><affiliation><inist:fA14 i1="14"><s1>Department of Urology, Semmelweis University</s1><s2>Budapest</s2><s3>HUN</s3><sZ>13 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Nilsson, Andreas" sort="Nilsson, Andreas" uniqKey="Nilsson A" first="Andreas" last="Nilsson">Andreas Nilsson</name><affiliation><inist:fA14 i1="02"><s1>Department of Molecular Medicine and Surgery, Karolinska Institutet</s1><s2>Stockholm</s2><s3>SWE</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Carlsson, Stefan" sort="Carlsson, Stefan" uniqKey="Carlsson S" first="Stefan" last="Carlsson">Stefan Carlsson</name><affiliation><inist:fA14 i1="02"><s1>Department of Molecular Medicine and Surgery, Karolinska Institutet</s1><s2>Stockholm</s2><s3>SWE</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Xylinas, Evanguelos" sort="Xylinas, Evanguelos" uniqKey="Xylinas E" first="Evanguelos" last="Xylinas">Evanguelos Xylinas</name><affiliation><inist:fA14 i1="04"><s1>Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital</s1><s2>New York, NY</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>16 aut.</sZ><sZ>29 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Loidl, Wolfgang" sort="Loidl, Wolfgang" uniqKey="Loidl W" first="Wolfgang" last="Loidl">Wolfgang Loidl</name><affiliation><inist:fA14 i1="15"><s1>Department of Urology, St. Vincent's Hospital</s1><s2>Linz</s2><s3>AUT</s3><sZ>17 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Seitz, Christian" sort="Seitz, Christian" uniqKey="Seitz C" first="Christian" last="Seitz">Christian Seitz</name><affiliation><inist:fA14 i1="05"><s1>Department of Urology, Medical University of Vienna</s1><s2>Vienna</s2><s3>AUT</s3><sZ>3 aut.</sZ><sZ>18 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Schramek, Paul" sort="Schramek, Paul" uniqKey="Schramek P" first="Paul" last="Schramek">Paul Schramek</name><affiliation><inist:fA14 i1="16"><s1>Department of Urology, Saint John of God Hospital</s1><s2>Vienna</s2><s3>AUT</s3><sZ>19 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Roehrborn, Claus" sort="Roehrborn, Claus" uniqKey="Roehrborn C" first="Claus" last="Roehrborn">Claus Roehrborn</name><affiliation><inist:fA14 i1="17"><s1>Department of Urology, University of Texas Southwestern Medical Center</s1><s2>Dallas, TX</s2><s3>USA</s3><sZ>20 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Cathelineau, Xavier" sort="Cathelineau, Xavier" uniqKey="Cathelineau X" first="Xavier" last="Cathelineau">Xavier Cathelineau</name><affiliation><inist:fA14 i1="09"><s1>Department of Urology, L'Institut Mutualiste Montsouris</s1><s2>Paris</s2><s3>FRA</s3><sZ>8 aut.</sZ><sZ>21 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Skarecky, Douglas" sort="Skarecky, Douglas" uniqKey="Skarecky D" first="Douglas" last="Skarecky">Douglas Skarecky</name><affiliation><inist:fA14 i1="07"><s1>Department of Urology, University of California-Irvine School of Medicine</s1><s2>Irvine, CA</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>22 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Shaw, Greg" sort="Shaw, Greg" uniqKey="Shaw G" first="Greg" last="Shaw">Greg Shaw</name><affiliation><inist:fA14 i1="13"><s1>Uro-oncology Research Group, Cancer Research UK, Cambridge Research Institute</s1><s2>Cambridge</s2><s3>GBR</s3><sZ>11 aut.</sZ><sZ>23 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Warren, Anne" sort="Warren, Anne" uniqKey="Warren A" first="Anne" last="Warren">Anne Warren</name><affiliation><inist:fA14 i1="18"><s1>Department of Histopathology, Cambridge University Hospitals NHS Foundation Trust</s1><s2>Cambridge</s2><s3>GBR</s3><sZ>24 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Delprado, Warick J" sort="Delprado, Warick J" uniqKey="Delprado W" first="Warick J." last="Delprado">Warick J. Delprado</name><affiliation><inist:fA14 i1="06"><s1>Prostate Cancer Centre, St. Vincent's Clinic</s1><s2>Sydney</s2><s3>AUS</s3><sZ>4 aut.</sZ><sZ>25 aut.</sZ><sZ>26 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Haynes, Anne Marie" sort="Haynes, Anne Marie" uniqKey="Haynes A" first="Anne-Marie" last="Haynes">Anne-Marie Haynes</name><affiliation><inist:fA14 i1="06"><s1>Prostate Cancer Centre, St. Vincent's Clinic</s1><s2>Sydney</s2><s3>AUS</s3><sZ>4 aut.</sZ><sZ>25 aut.</sZ><sZ>26 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Steyerberg, Ewout" sort="Steyerberg, Ewout" uniqKey="Steyerberg E" first="Ewout" last="Steyerberg">Ewout Steyerberg</name><affiliation><inist:fA14 i1="19"><s1>Department of Public Health, Erasmus MC-University Medical Center Rotterdam</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>27 aut.</sZ><sZ>28 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Roobol, Monique J" sort="Roobol, Monique J" uniqKey="Roobol M" first="Monique J." last="Roobol">Monique J. Roobol</name><affiliation><inist:fA14 i1="19"><s1>Department of Public Health, Erasmus MC-University Medical Center Rotterdam</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>27 aut.</sZ><sZ>28 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Tewari, Ashutosh K" sort="Tewari, Ashutosh K" uniqKey="Tewari A" first="Ashutosh K." last="Tewari">Ashutosh K. Tewari</name><affiliation><inist:fA14 i1="04"><s1>Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital</s1><s2>New York, NY</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>16 aut.</sZ><sZ>29 aut.</sZ></inist:fA14></affiliation></author></analytic><series><title level="j" type="main">European urology</title><title level="j" type="abbreviated">Eur. urol.</title><idno type="ISSN">0302-2838</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">European urology</title><title level="j" type="abbreviated">Eur. urol.</title><idno type="ISSN">0302-2838</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Comparative study</term><term>Endoscopic surgery</term><term>Human</term><term>Laparoscopic surgery</term><term>Laparoscopy</term><term>Nephrology</term><term>Prostatectomy</term><term>Rate</term><term>Robotics</term><term>Surgical margin</term><term>Telemedicine</term><term>Treatment</term><term>Urology</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Marge chirurgicale</term><term>Etude comparative</term><term>Chirurgie endoscopique</term><term>Taux</term><term>Prostatectomie</term><term>Coeliochirurgie</term><term>Robotique</term><term>Homme</term><term>Laparoscopie</term><term>Télémédecine</term><term>Néphrologie</term><term>Urologie</term><term>Traitement</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: Positive surgical margins (PSMs) are a known risk factor for biochemical recurrence in patients with prostate cancer (PCa) and are potentially affected by surgical technique and volume. Objective: To investigate whether radical prostatectomy (RP) modality and volume affect PSM rates. Design, setting, and participants: Fourteen institutions in Europe, the United States, and Australia were invited to participate in this study, all of which retrospectively provided margins data on 9778 open RP, 4918 laparoscopic RP, and 7697 robotic RP patients operated on between January 2000 and October 2011. Outcome measurements and statistical analyses: The outcome measure was PSM rate. Multivariable logistic regression analyses and propensity score methods identified odds ratios for risk of a PSM for one modality compared with another, after adjustment for age, preoperative prostate-specific antigen, postoperative Gleason score, pathologic stage, and year of surgery. Classic adjustment using standard covariates was also implemented to compare PSM rates based on center volume for each minimally invasive surgical cohort. Results and limitations: Open RP patients had higher-risk PCa at time of surgery on average and were operated on earlier in the study time period on average, compared with minimally invasive cohorts. Crude margin rates were lowest for robotic RP (13.8%), intermediate for laparoscopic RP (16.3%), and highest for open RP (22.8%); significant differences persisted, although were ameliorated, after statistical adjustments. Lower-volume centers had increased risks of PSM compared with the highest-volume center for both laparoscopic RP and robotic RP. The study is limited by its nonrandomized nature; missing data across covariates, especially year of surgery in many of the open cohort cases; lack of standardized histologic processing and central pathology review; and lack of information regarding potential confounders such as patient comorbidity, nerve-sparing status, lymph node status, tumor volume, and individual surgeon caseload.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0302-2838</s0></fA01><fA02 i1="01"><s0>EUURAV</s0></fA02><fA03 i2="1"><s0>Eur. urol.</s0></fA03><fA05><s2>66</s2></fA05><fA06><s2>3</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>A Multinational, Multi-institutional Study Comparing Positive Surgical Margin Rates Among 22 393 Open, Laparoscopic, and Robot-assisted Radical Prostatectomy Patients</s1></fA08><fA11 i1="01" i2="1"><s1>SOORIAKUMARAN (Prasanna)</s1></fA11><fA11 i1="02" i2="1"><s1>SRIVASTAVA (Abhishek)</s1></fA11><fA11 i1="03" i2="1"><s1>SHARIAT (Shahrokh F.)</s1></fA11><fA11 i1="04" i2="1"><s1>STRIEKER (Phillip D.)</s1></fA11><fA11 i1="05" i2="1"><s1>AHLERING (Thomas)</s1></fA11><fA11 i1="06" i2="1"><s1>EDEN (Christopher G.)</s1></fA11><fA11 i1="07" i2="1"><s1>WIKLUND (Peter N.)</s1></fA11><fA11 i1="08" i2="1"><s1>SANCHEZ-SALAS (Rafael)</s1></fA11><fA11 i1="09" i2="1"><s1>MOTTRIE (Alexandre)</s1></fA11><fA11 i1="10" i2="1"><s1>LEE (David)</s1></fA11><fA11 i1="11" i2="1"><s1>NEAL (David E.)</s1></fA11><fA11 i1="12" i2="1"><s1>GHAVAMIAN (Reza)</s1></fA11><fA11 i1="13" i2="1"><s1>NYIRADY (Peter)</s1></fA11><fA11 i1="14" i2="1"><s1>NILSSON (Andreas)</s1></fA11><fA11 i1="15" i2="1"><s1>CARLSSON (Stefan)</s1></fA11><fA11 i1="16" i2="1"><s1>XYLINAS (Evanguelos)</s1></fA11><fA11 i1="17" i2="1"><s1>LOIDL (Wolfgang)</s1></fA11><fA11 i1="18" i2="1"><s1>SEITZ (Christian)</s1></fA11><fA11 i1="19" i2="1"><s1>SCHRAMEK (Paul)</s1></fA11><fA11 i1="20" i2="1"><s1>ROEHRBORN (Claus)</s1></fA11><fA11 i1="21" i2="1"><s1>CATHELINEAU (Xavier)</s1></fA11><fA11 i1="22" i2="1"><s1>SKARECKY (Douglas)</s1></fA11><fA11 i1="23" i2="1"><s1>SHAW (Greg)</s1></fA11><fA11 i1="24" i2="1"><s1>WARREN (Anne)</s1></fA11><fA11 i1="25" i2="1"><s1>DELPRADO (Warick J.)</s1></fA11><fA11 i1="26" i2="1"><s1>HAYNES (Anne-Marie)</s1></fA11><fA11 i1="27" i2="1"><s1>STEYERBERG (Ewout)</s1></fA11><fA11 i1="28" i2="1"><s1>ROOBOL (Monique J.)</s1></fA11><fA11 i1="29" i2="1"><s1>TEWARI (Ashutosh K.)</s1></fA11><fA14 i1="01"><s1>Surgical Intervention Trials Unit, Nuffield Department of Surgical Sciences, University of Oxford</s1><s2>Oxford</s2><s3>GBR</s3><sZ>1 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Molecular Medicine and Surgery, Karolinska Institutet</s1><s2>Stockholm</s2><s3>SWE</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></fA14><fA14 i1="03"><s1>Department of Urology, Montefiore Medical Center</s1><s2>New York, NY</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>12 aut.</sZ></fA14><fA14 i1="04"><s1>Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital</s1><s2>New York, NY</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>16 aut.</sZ><sZ>29 aut.</sZ></fA14><fA14 i1="05"><s1>Department of Urology, Medical University of Vienna</s1><s2>Vienna</s2><s3>AUT</s3><sZ>3 aut.</sZ><sZ>18 aut.</sZ></fA14><fA14 i1="06"><s1>Prostate Cancer Centre, St. Vincent's Clinic</s1><s2>Sydney</s2><s3>AUS</s3><sZ>4 aut.</sZ><sZ>25 aut.</sZ><sZ>26 aut.</sZ></fA14><fA14 i1="07"><s1>Department of Urology, University of California-Irvine School of Medicine</s1><s2>Irvine, CA</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>22 aut.</sZ></fA14><fA14 i1="08"><s1>Department of Urology, Royal Surrey County Hospital</s1><s2>Guildford</s2><s3>GBR</s3><sZ>6 aut.</sZ></fA14><fA14 i1="09"><s1>Department of Urology, L'Institut Mutualiste Montsouris</s1><s2>Paris</s2><s3>FRA</s3><sZ>8 aut.</sZ><sZ>21 aut.</sZ></fA14><fA14 i1="10"><s1>Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital</s1><s2>Aalst</s2><s3>BEL</s3><sZ>9 aut.</sZ></fA14><fA14 i1="11"><s1>Department of Urology, University of Pennsylvania</s1><s2>Philadelphia, PA</s2><s3>USA</s3><sZ>10 aut.</sZ></fA14><fA14 i1="12"><s1>Department of Uro-oncology, University of Cambridge</s1><s2>Cambridge</s2><s3>GBR</s3><sZ>11 aut.</sZ></fA14><fA14 i1="13"><s1>Uro-oncology Research Group, Cancer Research UK, Cambridge Research Institute</s1><s2>Cambridge</s2><s3>GBR</s3><sZ>11 aut.</sZ><sZ>23 aut.</sZ></fA14><fA14 i1="14"><s1>Department of Urology, Semmelweis University</s1><s2>Budapest</s2><s3>HUN</s3><sZ>13 aut.</sZ></fA14><fA14 i1="15"><s1>Department of Urology, St. Vincent's Hospital</s1><s2>Linz</s2><s3>AUT</s3><sZ>17 aut.</sZ></fA14><fA14 i1="16"><s1>Department of Urology, Saint John of God Hospital</s1><s2>Vienna</s2><s3>AUT</s3><sZ>19 aut.</sZ></fA14><fA14 i1="17"><s1>Department of Urology, University of Texas Southwestern Medical Center</s1><s2>Dallas, TX</s2><s3>USA</s3><sZ>20 aut.</sZ></fA14><fA14 i1="18"><s1>Department of Histopathology, Cambridge University Hospitals NHS Foundation Trust</s1><s2>Cambridge</s2><s3>GBR</s3><sZ>24 aut.</sZ></fA14><fA14 i1="19"><s1>Department of Public Health, Erasmus MC-University Medical Center Rotterdam</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>27 aut.</sZ><sZ>28 aut.</sZ></fA14><fA20><s1>450-456</s1></fA20><fA21><s1>2014</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>16847</s2><s5>354000504835110130</s5></fA43><fA44><s0>0000</s0><s1>© 2014 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>27 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>14-0223163</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>European urology</s0></fA64><fA66 i1="01"><s0>GBR</s0></fA66><fC01 i1="01" l="ENG"><s0>Background: Positive surgical margins (PSMs) are a known risk factor for biochemical recurrence in patients with prostate cancer (PCa) and are potentially affected by surgical technique and volume. Objective: To investigate whether radical prostatectomy (RP) modality and volume affect PSM rates. Design, setting, and participants: Fourteen institutions in Europe, the United States, and Australia were invited to participate in this study, all of which retrospectively provided margins data on 9778 open RP, 4918 laparoscopic RP, and 7697 robotic RP patients operated on between January 2000 and October 2011. Outcome measurements and statistical analyses: The outcome measure was PSM rate. Multivariable logistic regression analyses and propensity score methods identified odds ratios for risk of a PSM for one modality compared with another, after adjustment for age, preoperative prostate-specific antigen, postoperative Gleason score, pathologic stage, and year of surgery. Classic adjustment using standard covariates was also implemented to compare PSM rates based on center volume for each minimally invasive surgical cohort. Results and limitations: Open RP patients had higher-risk PCa at time of surgery on average and were operated on earlier in the study time period on average, compared with minimally invasive cohorts. Crude margin rates were lowest for robotic RP (13.8%), intermediate for laparoscopic RP (16.3%), and highest for open RP (22.8%); significant differences persisted, although were ameliorated, after statistical adjustments. Lower-volume centers had increased risks of PSM compared with the highest-volume center for both laparoscopic RP and robotic RP. The study is limited by its nonrandomized nature; missing data across covariates, especially year of surgery in many of the open cohort cases; lack of standardized histologic processing and central pathology review; and lack of information regarding potential confounders such as patient comorbidity, nerve-sparing status, lymph node status, tumor volume, and individual surgeon caseload.</s0></fC01><fC02 i1="01" i2="X"><s0>002B14</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Marge chirurgicale</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Surgical margin</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Margen quirúrgica</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Etude comparative</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Comparative study</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Estudio comparativo</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Chirurgie endoscopique</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Endoscopic surgery</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Cirugía endoscópica</s0><s5>03</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Taux</s0><s5>05</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Rate</s0><s5>05</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Tasa</s0><s5>05</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Prostatectomie</s0><s5>06</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Prostatectomy</s0><s5>06</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Prostatectomía</s0><s5>06</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Coeliochirurgie</s0><s5>08</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Laparoscopic surgery</s0><s5>08</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Cirugía laparoscopica</s0><s5>08</s5></fC03><fC03 i1="07" i2="X" l="FRE"><s0>Robotique</s0><s5>09</s5></fC03><fC03 i1="07" i2="X" l="ENG"><s0>Robotics</s0><s5>09</s5></fC03><fC03 i1="07" i2="X" l="SPA"><s0>Robótica</s0><s5>09</s5></fC03><fC03 i1="08" i2="X" l="FRE"><s0>Homme</s0><s5>11</s5></fC03><fC03 i1="08" i2="X" l="ENG"><s0>Human</s0><s5>11</s5></fC03><fC03 i1="08" i2="X" l="SPA"><s0>Hombre</s0><s5>11</s5></fC03><fC03 i1="09" i2="X" l="FRE"><s0>Laparoscopie</s0><s5>12</s5></fC03><fC03 i1="09" i2="X" l="ENG"><s0>Laparoscopy</s0><s5>12</s5></fC03><fC03 i1="09" i2="X" l="SPA"><s0>Laparoscopia</s0><s5>12</s5></fC03><fC03 i1="10" i2="X" l="FRE"><s0>Télémédecine</s0><s5>17</s5></fC03><fC03 i1="10" i2="X" l="ENG"><s0>Telemedicine</s0><s5>17</s5></fC03><fC03 i1="10" i2="X" l="SPA"><s0>Telemedicina</s0><s5>17</s5></fC03><fC03 i1="11" i2="X" l="FRE"><s0>Néphrologie</s0><s5>18</s5></fC03><fC03 i1="11" i2="X" l="ENG"><s0>Nephrology</s0><s5>18</s5></fC03><fC03 i1="11" i2="X" l="SPA"><s0>Nefrología</s0><s5>18</s5></fC03><fC03 i1="12" i2="X" l="FRE"><s0>Urologie</s0><s5>19</s5></fC03><fC03 i1="12" i2="X" l="ENG"><s0>Urology</s0><s5>19</s5></fC03><fC03 i1="12" i2="X" l="SPA"><s0>Urología</s0><s5>19</s5></fC03><fC03 i1="13" i2="X" l="FRE"><s0>Traitement</s0><s5>25</s5></fC03><fC03 i1="13" i2="X" l="ENG"><s0>Treatment</s0><s5>25</s5></fC03><fC03 i1="13" i2="X" l="SPA"><s0>Tratamiento</s0><s5>25</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Endoscopie</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Endoscopy</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Endoscopía</s0><s5>37</s5></fC07><fN21><s1>265</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard><server><NO>PASCAL 14-0223163 INIST</NO><ET>A Multinational, Multi-institutional Study Comparing Positive Surgical Margin Rates Among 22 393 Open, Laparoscopic, and Robot-assisted Radical Prostatectomy Patients</ET><AU>SOORIAKUMARAN (Prasanna); SRIVASTAVA (Abhishek); SHARIAT (Shahrokh F.); STRIEKER (Phillip D.); AHLERING (Thomas); EDEN (Christopher G.); WIKLUND (Peter N.); SANCHEZ-SALAS (Rafael); MOTTRIE (Alexandre); LEE (David); NEAL (David E.); GHAVAMIAN (Reza); NYIRADY (Peter); NILSSON (Andreas); CARLSSON (Stefan); XYLINAS (Evanguelos); LOIDL (Wolfgang); SEITZ (Christian); SCHRAMEK (Paul); ROEHRBORN (Claus); CATHELINEAU (Xavier); SKARECKY (Douglas); SHAW (Greg); WARREN (Anne); DELPRADO (Warick J.); HAYNES (Anne-Marie); STEYERBERG (Ewout); ROOBOL (Monique J.); TEWARI (Ashutosh K.)</AU><AF>Surgical Intervention Trials Unit, Nuffield Department of Surgical Sciences, University of Oxford/Oxford/Royaume-Uni (1 aut.); Department of Molecular Medicine and Surgery, Karolinska Institutet/Stockholm/Suède (1 aut., 7 aut., 14 aut., 15 aut.); Department of Urology, Montefiore Medical Center/New York, NY/Etats-Unis (2 aut., 12 aut.); Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital/New York, NY/Etats-Unis (3 aut., 16 aut., 29 aut.); Department of Urology, Medical University of Vienna/Vienna/Autriche (3 aut., 18 aut.); Prostate Cancer Centre, St. Vincent's Clinic/Sydney/Australie (4 aut., 25 aut., 26 aut.); Department of Urology, University of California-Irvine School of Medicine/Irvine, CA/Etats-Unis (5 aut., 22 aut.); Department of Urology, Royal Surrey County Hospital/Guildford/Royaume-Uni (6 aut.); Department of Urology, L'Institut Mutualiste Montsouris/Paris/France (8 aut., 21 aut.); Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital/Aalst/Belgique (9 aut.); Department of Urology, University of Pennsylvania/Philadelphia, PA/Etats-Unis (10 aut.); Department of Uro-oncology, University of Cambridge/Cambridge/Royaume-Uni (11 aut.); Uro-oncology Research Group, Cancer Research UK, Cambridge Research Institute/Cambridge/Royaume-Uni (11 aut., 23 aut.); Department of Urology, Semmelweis University/Budapest/Hongrie (13 aut.); Department of Urology, St. Vincent's Hospital/Linz/Autriche (17 aut.); Department of Urology, Saint John of God Hospital/Vienna/Autriche (19 aut.); Department of Urology, University of Texas Southwestern Medical Center/Dallas, TX/Etats-Unis (20 aut.); Department of Histopathology, Cambridge University Hospitals NHS Foundation Trust/Cambridge/Royaume-Uni (24 aut.); Department of Public Health, Erasmus MC-University Medical Center Rotterdam/Rotterdam/Pays-Bas (27 aut., 28 aut.)</AF><DT>Publication en série; Niveau analytique</DT><SO>European urology; ISSN 0302-2838; Coden EUURAV; Royaume-Uni; Da. 2014; Vol. 66; No. 3; Pp. 450-456; Bibl. 27 ref.</SO><LA>Anglais</LA><EA>Background: Positive surgical margins (PSMs) are a known risk factor for biochemical recurrence in patients with prostate cancer (PCa) and are potentially affected by surgical technique and volume. Objective: To investigate whether radical prostatectomy (RP) modality and volume affect PSM rates. Design, setting, and participants: Fourteen institutions in Europe, the United States, and Australia were invited to participate in this study, all of which retrospectively provided margins data on 9778 open RP, 4918 laparoscopic RP, and 7697 robotic RP patients operated on between January 2000 and October 2011. Outcome measurements and statistical analyses: The outcome measure was PSM rate. Multivariable logistic regression analyses and propensity score methods identified odds ratios for risk of a PSM for one modality compared with another, after adjustment for age, preoperative prostate-specific antigen, postoperative Gleason score, pathologic stage, and year of surgery. Classic adjustment using standard covariates was also implemented to compare PSM rates based on center volume for each minimally invasive surgical cohort. Results and limitations: Open RP patients had higher-risk PCa at time of surgery on average and were operated on earlier in the study time period on average, compared with minimally invasive cohorts. Crude margin rates were lowest for robotic RP (13.8%), intermediate for laparoscopic RP (16.3%), and highest for open RP (22.8%); significant differences persisted, although were ameliorated, after statistical adjustments. Lower-volume centers had increased risks of PSM compared with the highest-volume center for both laparoscopic RP and robotic RP. The study is limited by its nonrandomized nature; missing data across covariates, especially year of surgery in many of the open cohort cases; lack of standardized histologic processing and central pathology review; and lack of information regarding potential confounders such as patient comorbidity, nerve-sparing status, lymph node status, tumor volume, and individual surgeon caseload.</EA><CC>002B14</CC><FD>Marge chirurgicale; Etude comparative; Chirurgie endoscopique; Taux; Prostatectomie; Coeliochirurgie; Robotique; Homme; Laparoscopie; Télémédecine; Néphrologie; Urologie; Traitement</FD><FG>Endoscopie</FG><ED>Surgical margin; Comparative study; Endoscopic surgery; Rate; Prostatectomy; Laparoscopic surgery; Robotics; Human; Laparoscopy; Telemedicine; Nephrology; Urology; Treatment</ED><EG>Endoscopy</EG><SD>Margen quirúrgica; Estudio comparativo; Cirugía endoscópica; Tasa; Prostatectomía; Cirugía laparoscopica; Robótica; Hombre; Laparoscopia; Telemedicina; Nefrología; Urología; Tratamiento</SD><LO>INIST-16847.354000504835110130</LO><ID>14-0223163</ID></server></inist></record>Pour manipuler ce document sous Unix (Dilib)
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