Evaluating Incidence, Location, and Predictors of Positive Surgical Margin Among Chinese Men Undergoing Robot-Assisted Radical Prostatectomy.

Abstract

PURPOSE:

To evaluate the incidence and locations of positive surgical margin (PSM) among Chinese men undergoing RARP and identify the preoperative predictors for PSM.

METHODS:

We retrospectively identified 393 patients who underwent RARP according to inclusion criteria by single surgeon in our hospital. PSM was defined as the presence of cancer adjacent to inked surface of the specimen and categorized into four groups based on locations: apex, posterolateral, base, and multifocal. Logistic regression analysis was performed to identify the predictors of overall and location-specific PSM.

RESULTS:

The overall PSM rate was 133/393 (34%). The PSM rates for pT2, pT3, and pT4 stage were 63/278 (23%), 50/89 (56%), and 20/26 (77%), respectively. The estimated rates for apical, posterolateral, basal, and multifocal PSM were 8%, 4%, 7%, and 14%, respectively. In univariate analysis, overall PSM related to tPSA, f/tPSA, percentage of positive needles, and Gleason score. Multifocal PSM correlated with smoking history, drinking history, tPSA, f/tPSA, percentage of positive needles, and Gleason score. In multivariate analysis, percentage of positive needles reminded the only independent predictor for overall (OR = 10.5, 95% CI: 2.58-44.4) and basal PSM (OR = 24.0, 95% CI: 3.22-179.4). The f/tPSA (OR = 2.59, 95% CI: 2.18-5.71) and percentage of positive needles (OR = 31.0, 95% CI: 3.17-303) were independent risk factors for multifocal PSM.

CONCLUSION:

The multifocal sites were the most common location of positive surgical margin, followed by apical and basal sites among Chinese patients undergoing RARP. The percentage of positive needles was an independent predictor for overall, basal, and multifocal PSM.

• Authors: Wugong Qu, Shuanbao Yu, Jin Tao, Biao Dong, Yafeng Fan, Haopeng Du, Haotian Deng, Junxiao Liu, Xuepei Zhang
• Journal: Cancer control : journal of the Moffitt Cancer Center (Cancer Control) 2021 Jan-Dec Vol. 28 Pg. 10732748211055265 ISSN: 1526-2359 [Electronic] United States
• PMID: 34794321 (Publication Type: Journal Article)

Topics

• Aged
• China
• Comorbidity
• Humans
• Incidence
• Logistic Models
• Male
• Margins of Excision
• Middle Aged
• Neoplasm Grading
• Neoplasm Recurrence, Local
• Prostatectomy (methods)
• Prostatic Neoplasms (pathology, surgery)
• Retrospective Studies
• Risk Factors
• Robotic Surgical Procedures (methods)