TY  - EJOU
AU  - Msezane, Lambda P. 
AU  - Gofrit, Ofer N. 
AU  - Lin, Shang 
AU  - Shalhav, Arieh L. 
AU  - Zagaja, Gregory P. 
AU  - Zorn, Kevin C. 

TI  - Prostate weight: an independent predictor for positive surgical margins during robotic-assisted laparoscopic radical prostatectomy
T2  - Canadian Journal of Urology

PY  - 2007
VL  - 14
IS  - 5
SN  - 1488-5581

AB  - <b>Introduction:</b> 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).
<br/><b>Methods:</b> 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.
<br/><b>Results:</b> 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).
<br/><b>Conclusions:</b> 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.
KW  - prostate cancer
KW  -  prostate weight
KW  -  laparoscopy
KW  -  robotic
KW  -  radical prostatectomy
KW  -  extracapsular extension
KW  -  positive surgical margins

DO  -