Neurovascular structure-adjacent frozen-section examination robotic-assisted radical prostatectomy : outcomes from 500 consecutive cases in the UK

© 2021. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature..

The purpose is to report the United Kingdom's largest single-centre experience of robotically assisted laparoscopic radical prostatectomies (RALP), using the neurovascular structure-adjacent frozen-section (NeuroSAFE) technique. We describe the utilisation and outcomes of this technique. This is a retrospective study from 2012 to 2019 on 520 patients undergoing NeuroSAFE RALP at our Institution. Our Institution's database was analysed for false-positive frozen-section (FS) margins as confirmed on paraffin histopathological analysis: functional outcomes of potency, continence, and biochemical recurrence (BCR). The median (range) of console time was 145 (90-300) min. In our cohort, positive FS was seen in 30.7% (160/520) of patients, with a confirmatory paraffin analysis in 91.8% of our patients' cohort (147/160). The neurovascular bundles (NVBs) that underwent secondary resection contained tumour in 26.8% (43/160) of the cases. Biochemical recurrence (BCR) was 6.7% (35/520), of which FS was positive in 40% (14/35) of those cases. There were insufficient evidence of a statistical association of urinary incontinence and positive surgical margin rates according to NS or NVB resection. NeuroSAFE enables intraoperative confirmation of the oncologic safety of a NS procedure. Patients with a positive FS on NeuroSAFE can be converted to a negative surgical margin (NSM) by ipsilateral wide resection. This spared 1 in 4 men from positive margins posterolaterally in our series. Limitations are the absence of a matched contemporary cohort of NS RALP without NeuroSAFE in our centre.

Errataetall:

ErratumIn: J Robot Surg. 2021 Nov 27;:. - PMID 34837594

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:16

Enthalten in:

Journal of robotic surgery - 16(2022), 4 vom: 30. Aug., Seite 951-956

Sprache:

Englisch

Beteiligte Personen:

Noël, Jonathan [VerfasserIn]
Spencer, Neil H [VerfasserIn]
Lodia, Siya [VerfasserIn]
Karim, Seiver [VerfasserIn]
Taneja, Surina [VerfasserIn]
Moghanchizadeh, Darius [VerfasserIn]
Nayak, Arvind [VerfasserIn]
Tamhankar, Ashwin [VerfasserIn]
Angra, Seema [VerfasserIn]
Swamy, Rajiv [VerfasserIn]
Agarwal, Samita [VerfasserIn]
Narula, Ashish [VerfasserIn]
Lane, Tim [VerfasserIn]
Adshead, Jim [VerfasserIn]
Vasdev, Nikhil [VerfasserIn]

Links:

Volltext

Themen:

8002-74-2
Frozen section
Journal Article
NeuroSAFE
Outcomes
Paraffin
Prostate cancer
Prostatectomy
Robotics

Anmerkungen:

Date Completed 27.07.2022

Date Revised 27.07.2022

published: Print-Electronic

ErratumIn: J Robot Surg. 2021 Nov 27;:. - PMID 34837594

Citation Status MEDLINE

doi:

10.1007/s11701-021-01324-2

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM332551555