ArticleJournal of the Chinese Medical Association : JCMA2022
Effects of nerve-sparing procedures on surgical margins after robot-assisted radical prostatectomy.
Article in Journal of the Chinese Medical Association : JCMA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 12 citations in OpenAlex.
- Winners of the 2022 honor awards for excellence at the annual meeting of the Chinese Medical Association-Taipei: Part III.Journal of the Chinese Medical Association : JCMA · 2023Article
- Nerve-sparing robotic-assisted radical prostatectomy is not associated with an increased rate of positive surgical margins.Journal of the Chinese Medical Association : JCMA · 2023Article
- Reply to "Nerve sparing robotic-assisted radical prostatectomy is not associated with an increased rate of positive surgical margins".Journal of the Chinese Medical Association : JCMA · 2023Article
- Minimally invasive surgery for hepatocellular carcinoma.Journal of the Chinese Medical Association : JCMA · 2023Article
- Risk-stratification system for preoperative evaluation.Journal of the Chinese Medical Association : JCMA · 2023Article
- The impact of nerve-sparing robotic-assisted radical prostatectomy on positive surgical margins: Uncertainty.Journal of the Chinese Medical Association : JCMA · 2023Article
- Reply to "The impact of nerve sparing robotic-assisted radical prostatectomy on positive surgical margins: Uncertainty".Journal of the Chinese Medical Association : JCMA · 2023Article
- A trend to minimize the radicality of surgery.Journal of the Chinese Medical Association : JCMA · 2023Article
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNerve-sparing (NS) techniques could potentially increase positive surgical margins after robot-assisted radical prostatectomy (RARP). Nevertheless, the available studies have revealed ambiguous results among distinct groups. This study purposed to clarify the details of NS techniques to accurately estimate their influence on margin status.
methodsWe studied RARPs performed by one surgeon from 2010 to 2018. Surgical margins were evaluated by the laterality and levels of NS techniques in site-specific prostate lobes. The multivariable analysis evaluated the effects of nerve-sparing procedures, combined with other covariate factors, on margin status.
resultsOverall, 419 RARPs involving 838 prostate lobes were analyzed. Notably, 181 patients (43.4%) had pT2-stage, and 236 (56.6%) had pT3-stage cancer. The PSM rates for patients who underwent unilateral, bilateral, and non NS procedures were 30.3%, 28.8%, and 50%, respectively ( p = 0.233) or in stratification by pT2 ( p = 0.584) and pT3 ( p = 0.116) stage. The posterolateral PSM rates among site-specific prostate lobes were 10.9%, 22.4%, and 18.9% for complete, partial, and non NS techniques, respectively ( p = 0.001). The partial NS group revealed a significant increase in PSM rate compared with the complete NS (OR 2.187, 95% CI: 1.19-4.03) and non NS (OR 2.237, 95% CI: 1.01-4.93) groups in site-specific prostate lobes.
conclusionPartial NS procedures have a potential risk of increasing the positive surgical margins rate than complete and non NS procedures do. Therefore, correct case selection is required before performing partial NS techniques.
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