Positive Surgical Margins After Robotic Assisted Radical Prostatectomy: A Multi-Institutional Study
dc.contributor | Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP | |
dc.contributor.author | PATEL, Vipul R. | |
dc.contributor.author | COELHO, Rafael F. | |
dc.contributor.author | ROCCO, Bernardo | |
dc.contributor.author | ORVIETO, Marcelo | |
dc.contributor.author | SIVARAMAN, Ananthakrishnan | |
dc.contributor.author | PALMER, Kenneth J. | |
dc.contributor.author | KAMEH, Darien | |
dc.contributor.author | SANTORO, Luigi | |
dc.contributor.author | COUGHLIN, Geoff D. | |
dc.contributor.author | LISS, Michael | |
dc.contributor.author | JEONG, Wooju | |
dc.contributor.author | MALCOLM, John | |
dc.contributor.author | STERN, Joshua M. | |
dc.contributor.author | SHARMA, Saurabh | |
dc.contributor.author | ZORN, Kevin C. | |
dc.contributor.author | SHIKANOV, Sergey | |
dc.contributor.author | SHALHAV, Arieh L. | |
dc.contributor.author | ZAGAJA, Gregory P. | |
dc.contributor.author | AHLERING, Thomas E. | |
dc.contributor.author | RHA, Koon H. | |
dc.contributor.author | ALBALA, David M. | |
dc.contributor.author | FABRIZIO, Michael D. | |
dc.contributor.author | LEE, David I. | |
dc.contributor.author | CHAUHAN, Sanket | |
dc.date.accessioned | 2017-11-27T16:38:07Z | |
dc.date.available | 2017-11-27T16:38:07Z | |
dc.date.issued | 2011 | |
dc.description.abstract | 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 <0.001) and preoperative prostate specific antigen (4 or less vs greater than 10 ng/ml OR 2.918, p <0.001) were the most important independent predictive factors for positive surgical margins after robotic assisted radical prostatectomy. Increasing prostate weight was associated with a lower risk of positive surgical margins after robotic assisted radical prostatectomy (OR 0.984, p <0.001) and a higher body mass index was associated with a higher risk of positive surgical margins (OR 1.032, p <0.001). For organ confined disease preoperative prostate specific antigen was the most important factor that independently correlated with positive surgical margins (4 or less vs greater than 10 ng/ml OR 3.8, p <0.001). Conclusions: The prostatic apex followed by a posterolateral site was the most common location of positive surgical margins after robotic assisted radical prostatectomy. Factors that correlated with cancer aggressiveness, such as pathological stage and preoperative prostate specific antigen, were the most important factors independently associated with an increased risk of positive surgical margins after robotic assisted radical prostatectomy. | |
dc.description.index | MEDLINE | |
dc.identifier.citation | JOURNAL OF UROLOGY, v.186, n.2, p.511-516, 2011 | |
dc.identifier.doi | 10.1016/j.juro.2011.03.112 | |
dc.identifier.issn | 0022-5347 | |
dc.identifier.uri | https://observatorio.fm.usp.br/handle/OPI/23611 | |
dc.language.iso | eng | |
dc.publisher | ELSEVIER SCIENCE INC | |
dc.relation.ispartof | Journal of Urology | |
dc.rights | restrictedAccess | |
dc.rights.holder | Copyright ELSEVIER SCIENCE INC | |
dc.subject | prostate | |
dc.subject | prostatic neoplasms | |
dc.subject | prostatectomy | |
dc.subject | robotics | |
dc.subject | neoplasm recurrence | |
dc.subject | local | |
dc.subject.other | body-mass index | |
dc.subject.other | laparoscopic prostatectomy | |
dc.subject.other | retropubic prostatectomy | |
dc.subject.other | biochemical recurrence | |
dc.subject.other | risk-factors | |
dc.subject.other | outcomes | |
dc.subject.other | impact | |
dc.subject.other | location | |
dc.subject.other | cancer | |
dc.subject.other | weight | |
dc.subject.wos | Urology & Nephrology | |
dc.title | Positive Surgical Margins After Robotic Assisted Radical Prostatectomy: A Multi-Institutional Study | |
dc.type | article | |
dc.type.category | original article | |
dc.type.version | publishedVersion | |
dspace.entity.type | Publication | |
hcfmusp.affiliation.country | Estados Unidos | |
hcfmusp.affiliation.country | Itália | |
hcfmusp.affiliation.country | Coréia do Sul | |
hcfmusp.affiliation.countryiso | us | |
hcfmusp.affiliation.countryiso | it | |
hcfmusp.affiliation.countryiso | kr | |
hcfmusp.author.external | PATEL, Vipul R.:Univ Cent Florida, Coll Med, Florida Hosp Celebrat Hlth, Global Robot Inst, Orlando, FL 32816 USA | |
hcfmusp.author.external | ROCCO, Bernardo:Univ Cent Florida, Coll Med, Florida Hosp Celebrat Hlth, Global Robot Inst, Orlando, FL 32816 USA; Univ Milan, Sez Urol, Milan, Italy | |
hcfmusp.author.external | ORVIETO, Marcelo:Univ Cent Florida, Coll Med, Florida Hosp Celebrat Hlth, Global Robot Inst, Orlando, FL 32816 USA | |
hcfmusp.author.external | SIVARAMAN, Ananthakrishnan:Univ Cent Florida, Coll Med, Florida Hosp Celebrat Hlth, Global Robot Inst, Orlando, FL 32816 USA | |
hcfmusp.author.external | PALMER, Kenneth J.:Univ Cent Florida, Coll Med, Florida Hosp Celebrat Hlth, Global Robot Inst, Orlando, FL 32816 USA | |
hcfmusp.author.external | KAMEH, Darien:Univ Cent Florida, Coll Med, Florida Hosp Celebrat Hlth, Global Robot Inst, Orlando, FL 32816 USA | |
hcfmusp.author.external | SANTORO, Luigi:Univ Cent Florida, Coll Med, Florida Hosp Celebrat Hlth, Global Robot Inst, Orlando, FL 32816 USA | |
hcfmusp.author.external | COUGHLIN, Geoff D.:Univ Cent Florida, Coll Med, Florida Hosp Celebrat Hlth, Global Robot Inst, Orlando, FL 32816 USA | |
hcfmusp.author.external | LISS, Michael:Univ Calif Irvine, Irvine, CA USA | |
hcfmusp.author.external | JEONG, Wooju:Yonsei Univ, Coll Med, Seoul, South Korea | |
hcfmusp.author.external | MALCOLM, John:E Virginia Med Sch, Norfolk, VA USA | |
hcfmusp.author.external | STERN, Joshua M.:Univ Penn, Sch Med, Philadelphia, PA 19104 USA | |
hcfmusp.author.external | SHARMA, Saurabh:Univ Penn, Sch Med, Philadelphia, PA 19104 USA | |
hcfmusp.author.external | ZORN, Kevin C.:Univ Chicago, Med Ctr, Chicago, IL 60637 USA | |
hcfmusp.author.external | SHIKANOV, Sergey:Univ Chicago, Med Ctr, Chicago, IL 60637 USA | |
hcfmusp.author.external | SHALHAV, Arieh L.:Univ Chicago, Med Ctr, Chicago, IL 60637 USA | |
hcfmusp.author.external | ZAGAJA, Gregory P.:Univ Chicago, Med Ctr, Chicago, IL 60637 USA | |
hcfmusp.author.external | AHLERING, Thomas E.:Univ Calif Irvine, Irvine, CA USA | |
hcfmusp.author.external | RHA, Koon H.:Yonsei Univ, Coll Med, Seoul, South Korea | |
hcfmusp.author.external | ALBALA, David M.:Duke Univ, Med Ctr, Durham, NC USA | |
hcfmusp.author.external | FABRIZIO, Michael D.:E Virginia Med Sch, Norfolk, VA USA | |
hcfmusp.author.external | LEE, David I.:Univ Penn, Sch Med, Philadelphia, PA 19104 USA | |
hcfmusp.author.external | CHAUHAN, Sanket:Univ Cent Florida, Coll Med, Florida Hosp Celebrat Hlth, Global Robot Inst, Orlando, FL 32816 USA | |
hcfmusp.citation.scopus | 128 | |
hcfmusp.contributor.author-fmusphc | RAFAEL FERREIRA COELHO | |
hcfmusp.description.beginpage | 511 | |
hcfmusp.description.endpage | 516 | |
hcfmusp.description.issue | 2 | |
hcfmusp.description.volume | 186 | |
hcfmusp.origem | WOS | |
hcfmusp.origem.pubmed | 21680001 | |
hcfmusp.origem.scopus | 2-s2.0-79960171435 | |
hcfmusp.origem.wos | WOS:000292545100042 | |
hcfmusp.publisher.city | NEW YORK | |
hcfmusp.publisher.country | USA | |
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hcfmusp.scopus.lastupdate | 2024-05-17 | |
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