ReviewBJU international2022
NeuroSAFE in radical prostatectomy increases the rate of nerve-sparing surgery without affecting oncological outcome.
Review in BJU international, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- NeuroSAFE-guided robot-assisted radical prostatectomy versus standard RARP: systematic review and meta-analysis of comparative studies.Journal of robotic surgery · 2026Pooled it
- Neurovascular structure-adjacent frozen-section examination (NeuroSAFE) during robot-assisted radical prostatectomy: a systematic review and meta-analysis of comparative studies.Prostate cancer and prostatic diseases · 2025Pooled it
- Neurovascular structure-adjacent frozen-section examination vs. standard robot-assisted radical prostatectomy: a systematic review and meta-analysis of two-arm comparative studies on functional and oncological outcomes.Journal of robotic surgery · 2025Pooled it
- The cost-effectiveness of intraoperative margin assessment strategies during radical prostatectomy.BJU international · 2026Article
- Delphi consensus on ex vivo fluorescence confocal microscopy in robot-assisted radical prostatectomy.BJU international · 2026Article
- Intraoperative margin assessment using fluorescence confocal microscopy during robot-assisted radical prostatectomy: a first experience.BJU international · 2026Observational
- Feasibility and workflow analysis of confocal microscopy in robot-assisted prostatectomy.BJU international · 2026Article
- Nerve-Sparing in High-Risk Prostate Cancer: Advantages and Pitfalls of Current Strategies and Technologies.Cancers · 2026Review
- Grossing and reporting of the radical prostatectomy specimen.Pathologie (Heidelberg, Germany) · 2025Review
- Enhancing nerve sparing in robotic prostate surgery: the impact of NeuroSAFE on fascia preservation score.Translational andrology and urology · 2025Article
- Next-Generation Nerve-Sparing Techniques in Robotic Radical Prostatectomy: A Contemporary Review.Current urology reports · 2025Review
- [Grossing and reporting of the radical prostatectomy specimen].Pathologie (Heidelberg, Germany) · 2025Review
- Positive surgical margin and oncological outcomes after robot-assisted radical prostatectomy in different Cancer of the Prostate Risk Assessment risk groups.BJU international · 2025Article
- Nerve-sparing radical prostatectomy using the neurovascular structure-adjacent frozen-section examination (NeuroSAFE): results after 20 years of experience.Prostate cancer and prostatic diseases · 2025Article
- Stimulated Raman Histology and Artificial Intelligence Provide Near Real-Time Interpretation of Radical Prostatectomy Surgical Margins.The Journal of urology · 2025Article
- Fluorescence confocal microscopy for margin assessment in prostatectomy: IP8-FLUORESCE study protocol.BJU international · 2025Article
- An updated model for predicting side-specific extraprostatic extension in the era of MRI-targeted biopsy.Prostate cancer and prostatic diseases · 2024Article
- Feasibility of Diffuse Reflection Spectroscopy for Intraoperative Margin Assessment During Prostatectomy.European urology open science · 2024Article
- Predicting contralateral extraprostatic extension in unilateral high-risk prostate cancer: a multicentric external validation study.World journal of urology · 2024Article
- Lymphoceles after pelvic lymph node dissection during robot-assisted radical prostatectomy.Translational andrology and urology · 2023Article
Corrections and comments
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Authors and funding
18 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo investigate the impact of intra-operative neurovascular structure-adjacent frozen-section examination (NeuroSAFE) on the rate of nerve-sparing surgery (NSS) and oncological outcome in a large radical prostatectomy (RP) cohort. PATIENTS AND
methodsBetween January 2016 and December 2020, 1756 prostate cancer patients underwent robot-assisted RP, of whom 959 (55%) underwent this with NeuroSAFE and 797 (45%) without (control cohort). In cases where NeuroSAFE showed tumour in the margin, a secondary resection was performed. The effect of NeuroSAFE on NSS and positive surgical margin (PSM) status was analysed using logistic regression. Cox regression was used to identify predictors of biochemical recurrence-free survival (BCRFS). RESULTS AND LIMITATIONS: Patients in the NeuroSAFE cohort had a higher tumour grade (P < 0.001) and clinical stage (P < 0.001) than those in the control cohort. NeuroSAFE enabled more frequent NSS for both pT2 (93% vs 76%; P < 0.001) and pT3 disease (83% vs 55%; P < 0.001). In adjusted analysis, NeuroSAFE resulted in more frequent unilateral (odds ratio [OR] 3.90, 95% confidence interval (CI) 2.90-5.30; P < 0.001) and bilateral (OR 5.22, 95% CI 3.90-6.98; P < 0.001) NSS. While the PSM rate decreased from 51% to 42% in patients with pT3 stage disease (P = 0.031), NeuroSAFE was not an independent predictor of PSM status (OR 0.85, 95% CI 0.68-1.06; P = 0.2) in the entire cohort. Patients who underwent NeuroSAFE had better BCRFS compared to the control cohort (hazard ratio 0.62, 95% CI 0.45-0.84; P = 0.002). This study is limited by its comparison with a historical cohort and lack of functional outcomes.
conclusionsNeuroSAFE enables more unilateral and bilateral NSS without negatively affecting surgical margin status and biochemical recurrence. This validation study provides a comprehensive overview of the implementation, evaluation and intra-operative decision making associated with NeuroSAFE in clinical practice.
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