We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Intrafascial Dissection Significantly Increases Positive Surgical Margin and Biochemical Recurrence Rates after Robotic-Assisted Radical Prostatectomy.
- Authors
Mortezavi, Ashkan; Hermanns, Thomas; Seifert, Hans-Helge; Wild, Peter J.; Schmid, Daniel M.; Sulser, Tullio; Eberli, Daniel
- Abstract
Introduction: Improved visualization and magnification in robot-assisted laparoscopic radical prostatectomy (RALRP) has tempted many urologists to dissect the neurovascular bundle closer to the prostate following the layers of the pseudo-capsule of the prostate. This might bear a higher risk of decreased tumor control. Materials and Methods: An analysis of a consecutive series of 186 patients who underwent RALRP at our institution was performed. The outcome of patients with intrafascial nerve-sparing (INS) was compared with the outcome of patients who underwent interfascial, extrafascial or no nerve-sparing (non-INS). Results: A total of 80 patients (43.0%) received INS. The overall R1 rate was 27.9%. For pT2 tumors the rate of R1 was 33.8% in INS versus 14.8% in non-INS (odds ratio 2.936, 95% confidence interval 1.338-6.443, p = 0.007). Recurrence-free survival was significantly shorter in INS (p = 0.05; hazard ratio 3.791). Conclusion: The intrafascial dissection technique for RALRP bears a high risk of incomplete resection in localized prostate cancer resulting in unfavorable outcome. Copyright © 2012 S. Karger AG, Basel
- Subjects
CANCER relapse; PROSTATECTOMY; LAPAROSCOPIC surgery; PROSTATE cancer treatment; HEALTH outcome assessment; PROSTATE surgery; TRANSURETHRAL prostatectomy
- Publication
Urologia Internationalis, 2012, Vol 89, Issue 1, p17
- ISSN
0042-1138
- Publication type
Article
- DOI
10.1159/000339254