Overall rate, location, and predictive factors for positive surgical margins after robot-assisted laparoscopic radical prostatectomy for high-risk prostate cancer
Identifieur interne : 000681 ( Main/Exploration ); précédent : 000680; suivant : 000682Overall rate, location, and predictive factors for positive surgical margins after robot-assisted laparoscopic radical prostatectomy for high-risk prostate cancer
Auteurs : Sung Gu Kang [Corée du Sud] ; Oscar Schatloff [États-Unis] ; Abdul Muhsin Haidar [États-Unis] ; Srinivas Samavedi [États-Unis] ; Kenneth J. Palmer [États-Unis] ; Jun Cheon [Corée du Sud] ; Vipul R. Patel [États-Unis]Source :
- Asian Journal of Andrology [ 1008-682X ] ; 2015.
Abstract
We report the overall rate, locations and predictive factors of positive surgical margins (PSMs) in 271 patients with high-risk prostate cancer. Between April 2008 and October 2011, we prospectively collected data from patients classified as D’Amico high-risk who underwent robot-assisted laparoscopic radical prostatectomy. Overall rate and location of PSMs were reported. Stepwise logistic regression models were fitted to assess predictive factors of PSM. The overall rate of PSMs was 25.1% (68 of 271 patients). Of these PSM, 38.2% (26 of 68) were posterolateral (PL), 26.5% (18 of 68) multifocal, 16.2% (11 of 68) in the apex, 14.7% (10 of 68) in the bladder neck, and 4.4% (3/68) in other locations. The PSM rate of patients with pathological stage pT2 was 8.6% (12 of 140), 26.6% (17 of 64) of pT3a, 53.3% (32/60) of pT3b, and 100% (7 of 7) of pT4. In a logistic regression model including pre-, intra-, and post-operative parameters, body mass index (odds ratio [OR]: 1.09; 95% confidence interval [CI]: 1.01–1.19,
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DOI: 10.4103/1008-682X.148723
PubMed: 25966623
PubMed Central: 4736340
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Overall rate, location, and predictive factors for positive surgical margins after robot-assisted laparoscopic radical prostatectomy for high-risk prostate cancer</title><author><name sortKey="Kang, Sung Gu" sort="Kang, Sung Gu" uniqKey="Kang S" first="Sung Gu" last="Kang">Sung Gu Kang</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Urology, Korea University School of Medicine, Seoul, Korea</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Urology, Korea University School of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement></placeName></affiliation></author><author><name sortKey="Schatloff, Oscar" sort="Schatloff, Oscar" uniqKey="Schatloff O" first="Oscar" last="Schatloff">Oscar Schatloff</name><affiliation wicri:level="2"><nlm:aff id="aff2">From the Global Robotics Institute, Florida Hospital Celebration Health, Celebration, and University of Central Florida School of Medicine, Orlando, Florida, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>From the Global Robotics Institute, Florida Hospital Celebration Health, Celebration, and University of Central Florida School of Medicine, Orlando, Florida</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Haidar, Abdul Muhsin" sort="Haidar, Abdul Muhsin" uniqKey="Haidar A" first="Abdul Muhsin" last="Haidar">Abdul Muhsin Haidar</name><affiliation wicri:level="2"><nlm:aff id="aff2">From the Global Robotics Institute, Florida Hospital Celebration Health, Celebration, and University of Central Florida School of Medicine, Orlando, Florida, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>From the Global Robotics Institute, Florida Hospital Celebration Health, Celebration, and University of Central Florida School of Medicine, Orlando, Florida</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Samavedi, Srinivas" sort="Samavedi, Srinivas" uniqKey="Samavedi S" first="Srinivas" last="Samavedi">Srinivas Samavedi</name><affiliation wicri:level="2"><nlm:aff id="aff2">From the Global Robotics Institute, Florida Hospital Celebration Health, Celebration, and University of Central Florida School of Medicine, Orlando, Florida, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>From the Global Robotics Institute, Florida Hospital Celebration Health, Celebration, and University of Central Florida School of Medicine, Orlando, Florida</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Palmer, Kenneth J" sort="Palmer, Kenneth J" uniqKey="Palmer K" first="Kenneth J" last="Palmer">Kenneth J. Palmer</name><affiliation wicri:level="2"><nlm:aff id="aff2">From the Global Robotics Institute, Florida Hospital Celebration Health, Celebration, and University of Central Florida School of Medicine, Orlando, Florida, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>From the Global Robotics Institute, Florida Hospital Celebration Health, Celebration, and University of Central Florida School of Medicine, Orlando, Florida</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Cheon, Jun" sort="Cheon, Jun" uniqKey="Cheon J" first="Jun" last="Cheon">Jun Cheon</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Urology, Korea University School of Medicine, Seoul, Korea</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Urology, Korea University School of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement></placeName></affiliation></author><author><name sortKey="Patel, Vipul R" sort="Patel, Vipul R" uniqKey="Patel V" first="Vipul R" last="Patel">Vipul R. Patel</name><affiliation wicri:level="2"><nlm:aff id="aff2">From the Global Robotics Institute, Florida Hospital Celebration Health, Celebration, and University of Central Florida School of Medicine, Orlando, Florida, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>From the Global Robotics Institute, Florida Hospital Celebration Health, Celebration, and University of Central Florida School of Medicine, Orlando, Florida</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25966623</idno><idno type="pmc">4736340</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4736340</idno><idno type="RBID">PMC:4736340</idno><idno type="doi">10.4103/1008-682X.148723</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000462</idno><idno type="wicri:Area/Pmc/Curation">000462</idno><idno type="wicri:Area/Pmc/Checkpoint">000416</idno><idno type="wicri:Area/Ncbi/Merge">003925</idno><idno type="wicri:Area/Ncbi/Curation">003925</idno><idno type="wicri:Area/Ncbi/Checkpoint">003925</idno><idno type="wicri:doubleKey">1008-682X:2015:Kang S:overall:rate:location</idno><idno type="wicri:Area/Main/Merge">000681</idno><idno type="wicri:Area/Main/Curation">000681</idno><idno type="wicri:Area/Main/Exploration">000681</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Overall rate, location, and predictive factors for positive surgical margins after robot-assisted laparoscopic radical prostatectomy for high-risk prostate cancer</title><author><name sortKey="Kang, Sung Gu" sort="Kang, Sung Gu" uniqKey="Kang S" first="Sung Gu" last="Kang">Sung Gu Kang</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Urology, Korea University School of Medicine, Seoul, Korea</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Urology, Korea University School of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement></placeName></affiliation></author><author><name sortKey="Schatloff, Oscar" sort="Schatloff, Oscar" uniqKey="Schatloff O" first="Oscar" last="Schatloff">Oscar Schatloff</name><affiliation wicri:level="2"><nlm:aff id="aff2">From the Global Robotics Institute, Florida Hospital Celebration Health, Celebration, and University of Central Florida School of Medicine, Orlando, Florida, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>From the Global Robotics Institute, Florida Hospital Celebration Health, Celebration, and University of Central Florida School of Medicine, Orlando, Florida</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Haidar, Abdul Muhsin" sort="Haidar, Abdul Muhsin" uniqKey="Haidar A" first="Abdul Muhsin" last="Haidar">Abdul Muhsin Haidar</name><affiliation wicri:level="2"><nlm:aff id="aff2">From the Global Robotics Institute, Florida Hospital Celebration Health, Celebration, and University of Central Florida School of Medicine, Orlando, Florida, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>From the Global Robotics Institute, Florida Hospital Celebration Health, Celebration, and University of Central Florida School of Medicine, Orlando, Florida</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Samavedi, Srinivas" sort="Samavedi, Srinivas" uniqKey="Samavedi S" first="Srinivas" last="Samavedi">Srinivas Samavedi</name><affiliation wicri:level="2"><nlm:aff id="aff2">From the Global Robotics Institute, Florida Hospital Celebration Health, Celebration, and University of Central Florida School of Medicine, Orlando, Florida, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>From the Global Robotics Institute, Florida Hospital Celebration Health, Celebration, and University of Central Florida School of Medicine, Orlando, Florida</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Palmer, Kenneth J" sort="Palmer, Kenneth J" uniqKey="Palmer K" first="Kenneth J" last="Palmer">Kenneth J. Palmer</name><affiliation wicri:level="2"><nlm:aff id="aff2">From the Global Robotics Institute, Florida Hospital Celebration Health, Celebration, and University of Central Florida School of Medicine, Orlando, Florida, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>From the Global Robotics Institute, Florida Hospital Celebration Health, Celebration, and University of Central Florida School of Medicine, Orlando, Florida</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Cheon, Jun" sort="Cheon, Jun" uniqKey="Cheon J" first="Jun" last="Cheon">Jun Cheon</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Urology, Korea University School of Medicine, Seoul, Korea</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Urology, Korea University School of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement></placeName></affiliation></author><author><name sortKey="Patel, Vipul R" sort="Patel, Vipul R" uniqKey="Patel V" first="Vipul R" last="Patel">Vipul R. Patel</name><affiliation wicri:level="2"><nlm:aff id="aff2">From the Global Robotics Institute, Florida Hospital Celebration Health, Celebration, and University of Central Florida School of Medicine, Orlando, Florida, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>From the Global Robotics Institute, Florida Hospital Celebration Health, Celebration, and University of Central Florida School of Medicine, Orlando, Florida</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation></author></analytic><series><title level="j">Asian Journal of Andrology</title><idno type="ISSN">1008-682X</idno><idno type="eISSN">1745-7262</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>We report the overall rate, locations and predictive factors of positive surgical margins (PSMs) in 271 patients with high-risk prostate cancer. Between April 2008 and October 2011, we prospectively collected data from patients classified as D’Amico high-risk who underwent robot-assisted laparoscopic radical prostatectomy. Overall rate and location of PSMs were reported. Stepwise logistic regression models were fitted to assess predictive factors of PSM. The overall rate of PSMs was 25.1% (68 of 271 patients). Of these PSM, 38.2% (26 of 68) were posterolateral (PL), 26.5% (18 of 68) multifocal, 16.2% (11 of 68) in the apex, 14.7% (10 of 68) in the bladder neck, and 4.4% (3/68) in other locations. The PSM rate of patients with pathological stage pT2 was 8.6% (12 of 140), 26.6% (17 of 64) of pT3a, 53.3% (32/60) of pT3b, and 100% (7 of 7) of pT4. In a logistic regression model including pre-, intra-, and post-operative parameters, body mass index (odds ratio [OR]: 1.09; 95% confidence interval [CI]: 1.01–1.19, <italic>P</italic>= 0.029), pathological stage (pT3b or higher <italic>vs</italic> pT2; OR: 5.14; 95% CI: 1.92–13.78; <italic>P</italic> = 0.001) and percentage of the tumor (OR: 46.71; 95% CI: 6.37–342.57; <italic>P</italic>< 0.001) were independent predictive factors for PSMs. The most common location of PSMs in patients at high-risk was the PL aspect, which reflects the reported tumor aggressiveness. The only significant predictive factors of PSMs were pathological outcomes, such as percentage of the tumor in the specimen and pathological stage.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Wilt, Tj" uniqKey="Wilt T">TJ Wilt</name></author><author><name sortKey="Brawer, Mk" uniqKey="Brawer M">MK Brawer</name></author><author><name sortKey="Jones, Km" uniqKey="Jones K">KM Jones</name></author><author><name sortKey="Barry, Mj" uniqKey="Barry M">MJ Barry</name></author><author><name sortKey="Aronson, Wj" uniqKey="Aronson W">WJ Aronson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bill Axelson, A" uniqKey="Bill Axelson A">A Bill-Axelson</name></author><author><name sortKey="Holmberg, L" uniqKey="Holmberg L">L Holmberg</name></author><author><name sortKey="Ruutu, M" uniqKey="Ruutu M">M Ruutu</name></author><author><name sortKey="Garmo, H" uniqKey="Garmo H">H Garmo</name></author><author><name 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Shariat</name></author><author><name sortKey="Stricker, Pd" uniqKey="Stricker P">PD Stricker</name></author><author><name sortKey="Ahlering, T" uniqKey="Ahlering T">T Ahlering</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fesseha, T" uniqKey="Fesseha T">T Fesseha</name></author><author><name sortKey="Sakr, W" uniqKey="Sakr W">W Sakr</name></author><author><name sortKey="Grignon, D" uniqKey="Grignon D">D Grignon</name></author><author><name sortKey="Banerjee, M" uniqKey="Banerjee M">M Banerjee</name></author><author><name sortKey="Wood, Dp" uniqKey="Wood D">DP Wood</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Eastham, Ja" uniqKey="Eastham J">JA Eastham</name></author><author><name sortKey="Kuroiwa, K" uniqKey="Kuroiwa K">K Kuroiwa</name></author><author><name sortKey="Ohori, M" uniqKey="Ohori M">M Ohori</name></author><author><name sortKey="Serio, Am" uniqKey="Serio A">AM Serio</name></author><author><name sortKey="Gorbonos, A" uniqKey="Gorbonos A">A Gorbonos</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Borin, Jf" uniqKey="Borin J">JF Borin</name></author><author><name sortKey="Skarecky, Dw" uniqKey="Skarecky D">DW Skarecky</name></author><author><name sortKey="Narula, N" uniqKey="Narula N">N Narula</name></author><author><name sortKey="Ahlering, Te" uniqKey="Ahlering T">TE Ahlering</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kordan, Y" uniqKey="Kordan Y">Y Kordan</name></author><author><name sortKey="Salem, S" uniqKey="Salem S">S Salem</name></author><author><name sortKey="Chang, Ss" uniqKey="Chang S">SS Chang</name></author><author><name sortKey="Clark, Pe" uniqKey="Clark P">PE Clark</name></author><author><name sortKey="Cookson, Ms" uniqKey="Cookson M">MS Cookson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Heidenreich, A" uniqKey="Heidenreich A">A Heidenreich</name></author><author><name sortKey="Bellmunt, J" uniqKey="Bellmunt J">J Bellmunt</name></author><author><name sortKey="Bolla, M" uniqKey="Bolla M">M Bolla</name></author><author><name sortKey="Joniau, S" uniqKey="Joniau S">S Joniau</name></author><author><name sortKey="Mason, M" uniqKey="Mason M">M Mason</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Corée du Sud</li><li>États-Unis</li></country><region><li>Floride</li></region><settlement><li>Séoul</li></settlement></list><tree><country name="Corée du Sud"><noRegion><name sortKey="Kang, Sung Gu" sort="Kang, Sung Gu" uniqKey="Kang S" first="Sung Gu" last="Kang">Sung Gu Kang</name></noRegion><name sortKey="Cheon, Jun" sort="Cheon, Jun" uniqKey="Cheon J" first="Jun" last="Cheon">Jun Cheon</name></country><country name="États-Unis"><region name="Floride"><name sortKey="Schatloff, Oscar" sort="Schatloff, Oscar" uniqKey="Schatloff O" first="Oscar" last="Schatloff">Oscar Schatloff</name></region><name sortKey="Haidar, Abdul Muhsin" sort="Haidar, Abdul Muhsin" uniqKey="Haidar A" first="Abdul Muhsin" last="Haidar">Abdul Muhsin Haidar</name><name sortKey="Palmer, Kenneth J" sort="Palmer, Kenneth J" uniqKey="Palmer K" first="Kenneth J" last="Palmer">Kenneth J. Palmer</name><name sortKey="Patel, Vipul R" sort="Patel, Vipul R" uniqKey="Patel V" first="Vipul R" last="Patel">Vipul R. Patel</name><name sortKey="Samavedi, Srinivas" sort="Samavedi, Srinivas" uniqKey="Samavedi S" first="Srinivas" last="Samavedi">Srinivas Samavedi</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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