Positive Surgical Margins After Robotic Assisted Radical Prostatectomy: A Multi-Institutional Study
Positive Surgical Margins After Robotic Assisted Radical Prostatectomy: A Multi-Institutional Study
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DOI：
10.1016/j.juro.2011.03.112
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发表时间：
2011-08-01
影响因子：
6.6
通讯作者：
Chauhan, Sanket
中科院分区：
文献类型：
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作者：
Patel, Vipul R.;Coelho, Rafael F.;Chauhan, Sanket
目的：手术切缘阳性是根治性前列腺切除术后生化复发的独立预测因素。我们分析了 8,418 例机器人辅助根治性前列腺切除术的多机构系列中阳性手术切缘的发生率和相关因素。材料和方法：我们分析了在 7 个机构接受机器人辅助根治性前列腺切除术的 8,418 名患者的记录。其中 323 名患者的切缘状态数据缺失。阳性手术切缘分为4组，包括顶端组、膀胱颈组、后外侧组和多灶组。 6,169 名患者的记录可用于多变量分析。输入逻辑回归模型的变量是年龄、体重指数、术前前列腺特异性抗原、活检格里森评分、前列腺重量和病理分期。建立第二个模型是为了确定器官局限性疾病 (pT2) 患者亚组中手术切缘阳性的预测因素。结果：整体手术切缘阳性率为 15.7%（8,095 名患者中的 1,272 名患者）。 pT2和pT3疾病的手术切缘阳性率分别为9.45%和37.2%。多变量分析病理分期（pT2 vs pT3 OR 4.588，p
Purpose: Positive surgical margins are an independent predictive factor for biochemical recurrence after radical prostatectomy. We analyzed the incidence of and associative factors for positive surgical margins in a multi-institutional series of 8,418 robotic assisted radical prostatectomies.Materials and Methods: We analyzed the records of 8,418 patients who underwent robotic assisted radical prostatectomy at 7 institutions. Of the patients 323 had missing data on margin status. Positive surgical margins were categorized into 4 groups, including apex, bladder neck, posterolateral and multifocal. The records of 6,169 patients were available for multivariate analysis. The variables entered into the logistic regression models were age, body mass index, preoperative prostate specific antigen, biopsy Gleason score, prostate weight and pathological stage. A second model was built to identify predictive factors for positive surgical margins in the subset of patients with organ confined disease (pT2).Results: The overall positive surgical margin rate was 15.7% (1,272 of 8,095 patients). The positive surgical margin rate for pT2 and pT3 disease was 9.45% and 37.2%, respectively. On multivariate analysis pathological stage (pT2 vs pT3 OR 4.588, p