Surgeon volume and body mass index influence positive surgical margin risk after robot-assisted radical prostatectomy: Results in 732 cases
| Autor: | Marco Pirozzi, Nelia Amigoni, Tania Processali, Matteo Brunelli, Antonio Benito Porcaro, Riccardo Bernasconi, Aliasger Shakir, Paolo Corsi, Giovanni Novella, Arianna Mariotto, Marco Sebben, Walter Artibani, Riccardo Rizzetto, Vincenzo De Marco, Giovanni Cacciamani, Alessandro Tafuri |
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| Rok vydání: | 2019 |
| Předmět: |
Biochemical recurrence
Surgical margin medicine.medical_specialty Prostate cancer body mass index positive surgical margins radical prostatectomy robotic surgery Urology medicine.medical_treatment Population 030232 urology & nephrology Laparoscopy/Robotics 03 medical and health sciences 0302 clinical medicine Interquartile range medicine Stage (cooking) education education.field_of_study 030219 obstetrics & reproductive medicine Prostatectomy business.industry Odds ratio Positive Surgical Margin business |
| Zdroj: | Arab Journal of Urology |
| ISSN: | 2090-598X |
| Popis: | Objectives: To evaluate clinicopathological and perioperative factors associated with the risk of focal and non-focal positive surgical margins (PSMs) after robot-assisted radical prostatectomy (RARP). Patients and methods: The study was retrospective and excluded patients who were under androgen-deprivation therapy or had prior treatments. The population included: negative SM cases (control group), focal and non-focal PSM cases (study groups). PSMs were classified as focal when the linear extent of cancer invasion was ≤1 mm and non-focal when >1 mm. The independent association of factors with the risk of focal and non-focal PSMs was assessed by multinomial logistic regression. Results: In all, 732 patients underwent RARP, from January 2013 to December 2017. An extended pelvic lymph node dissection was performed in 342 cases (46.7%). In all, 192 cases (26.3%) had PSMs, which were focal in 133 (18.2%) and non-focal in 59 (8.1%). Independent factors associated with the risk of focal PSMs were body mass index (odds ratio [OR] 0.914; P = 0.006), percentage of biopsy positive cores (BPC; OR 1.011; P = 0.015), pathological extracapsular extension (pathological tumour stage [pT]3a; OR 2.064; P = 0.016), and seminal vesicle invasion (pT3b; OR 2.150; P = 0.010). High surgeon volume was a protective factor in having focal PSM (OR 0.574; P = 0.006). Independent predictors of non-focal PSMs were BPC (OR 1,013; P = 0,044), pT3a (OR 4,832; P |
| Databáze: | OpenAIRE |
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