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MINIMALLY INVASIVE AND ROBOTIC SURGERY
Prostate weight: an independent predictor for positive surgical margins during robotic-assisted laparoscopic radical prostatectomy
Section of Urology, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
Address correspondence to Dr. Kevin Zorn, University of
Chicago, Section of Urology, 5841 S. Maryland Avenue,
MC6038, Chicago, IL 60637 USA
Canadian Journal of Urology 2007, 14(5), 3697-3701.
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Introduction: Pre-operative prediction of pathological stage represents the cornerstone of prostate cancer management. Patient counseling is routinely based on pre-operative PSA, Gleason score and clinical stage. In this study, we evaluated whether prostate weight (PW) is an independent predictor of extracapsular extension (ECE) and positive surgical margin (PSM).Methods: Between February 2003 and November 2006, 709 men underwent robotic-assisted laparoscopic radical prostatectomy (RLRP). Pre-operative parameters (patient age, pre-operative PSA, biopsy Gleason score, clinical stage) as well as pathological data (prostate weight, pathological stage) were prospectively gathered after internal-review board (IRB) approval. Evaluation of the influence of these variables on ECE and PSM outcomes were assessed using both univariate and multivariate logistic regression analysis.
Results: Mean overall patient age, pre-operative PSA and PW were 59.6 years, 6.5 ng/ml and 52.9 g (range 5.5 g-198.7 g), respectively. Of the 393, 209 and 107 men with PW < 50 g, 50 g-< 70 g and > 70 g, ECE was observed in 20.1%, 15.3% and 9.3%, respectively (p = 0.015). In the same patient cohorts, PSM was observed in 25.4%, 14.4% and 7.5%, respectively (p < 0.001). In a multivariate logistic regression analysis, PW, in addition to pre-operative PSA, biopsy Gleason score and clinical stage, was an independent risk factor for ECE (p < 0.001). Similarly, in multi-variate analysis, PW was observed to be a risk factor for PSM (p < 0.001).
Conclusions: PW is an independent predictor of both ECE and PSM, with an inverse relationship having been demonstrated between both variables. PW should be considered when counseling patients with prostate cancer treatment.
Keywords
prostate cancer, prostate weight, laparoscopy, robotic, radical prostatectomy, extracapsular extension, positive surgical margins
Cite This Article
APA Style
Msezane, L.P., Gofrit, O.N., Lin, S., Shalhav, A.L., Zagaja, G.P. et al. (2007). Prostate weight: an independent predictor for positive surgical margins during robotic-assisted laparoscopic radical prostatectomy. Canadian Journal of Urology, 14(5), 3697–3701.
Vancouver Style
Msezane LP, Gofrit ON, Lin S, Shalhav AL, Zagaja GP, Zorn KC. Prostate weight: an independent predictor for positive surgical margins during robotic-assisted laparoscopic radical prostatectomy. Can J Urology. 2007;14(5):3697–3701.
IEEE Style
L.P. Msezane, O.N. Gofrit, S. Lin, A.L. Shalhav, G.P. Zagaja, and K.C. Zorn, “Prostate weight: an independent predictor for positive surgical margins during robotic-assisted laparoscopic radical prostatectomy,” Can. J. Urology, vol. 14, no. 5, pp. 3697–3701, 2007.
Copyright © 2007 The Author(s). Published by Tech Science Press.This work is licensed under a Creative Commons Attribution 4.0 International License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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