ArticleProstate cancer and prostatic diseases2025
Nerve-sparing radical prostatectomy using the neurovascular structure-adjacent frozen-section examination (NeuroSAFE): results after 20 years of experience.
Article in Prostate cancer and prostatic diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- 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 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 LaserSAFE technique for margin assessment during radical prostatectomy: a feasibility study.BJU international · 2026Trial
- Intraoperative Techniques Aiding Margin Assessment and Nerve Sparing During Robot-Assisted Radical Prostatectomy.Cancers · 2026Review
- The cost-effectiveness of intraoperative margin assessment strategies during radical prostatectomy.BJU international · 2026Article
- Feasibility and workflow analysis of confocal microscopy in robot-assisted prostatectomy.BJU international · 2026Article
- Intraoperative margin assessment using fluorescence confocal microscopy during robot-assisted radical prostatectomy: a first experience.BJU international · 2026Observational
- Nerve-Sparing in High-Risk Prostate Cancer: Advantages and Pitfalls of Current Strategies and Technologies.Cancers · 2026Review
- Clarification of methodology and findings from the NeuroSAFE PROOF randomised controlled trial.Translational andrology and urology · 2026Article
- Evolution of the prostate cancer diagnostic paradigm: integrated evidence and clinical pathways from targeted biopsy to biopsy-free strategy.Frontiers in oncology · 2026Review
- Enhancing nerve sparing in robotic prostate surgery: the impact of NeuroSAFE on fascia preservation score.Translational andrology and urology · 2025Article
- Canadian Urological Association-European Association of Urology 2025 Exchange.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2025Article
- The impact of prostate volume on Retzius-sparing robot-assisted laparoscopic radical prostatectomy with retrograde release of the neurovascular bundle.BMC urology · 2025Article
- Article
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Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate the long-term oncological outcomes and functional results of the neurovascular structure-adjacent frozen-section examination (NeuroSAFE) during nerve-sparing (NS) radical prostatectomy (RP). MATERIALS AND
methodsA 10-yr survival analysis on 11069 RPs performed with or without the NeuroSAFE, between January 2002 to June 2011 was carried out. In the NeuroSAFE cohort, the neurovascular structure-adjacent prostatic margins are removed and stained for cryo-sectioning during RP. In case of a PSM, partial or full removal of the neurovascular bundle was performed. The impact of NeuroSAFE on biochemical recurrence-free survival (BFS), salvage radiation therapy-free survival, metastasis-free survival, and prostate cancer-specific survival at 10 years was analyzed. 1-year (1-yr) erectile function (EF), 1-yr, and 2-yr continence rates were assessed in propensity score-based matched cohorts.
resultsMedian follow-up was 121 (IQR: 73, 156) months. No differences in BFS between NeuroSAFE and non-NeuroSAFE were recorded (10-yr BFS: NeuroSAFE vs non-Neurosafe, pT2: 81% vs 84%, p = 0.06; pT3a: 58% vs. 63%, p = 0.6; ≥pT3b: 22% vs. 27%, p = 0.99). No differences were found between the two groups in terms of sRFS (pT2: p = 0.1; pT3a: p = 0.4; ≥pT3b: p = 0.4) (Fig. 1B, Table 2), and MTS (pT2: p = 0.3; pT3a: p = 0.6; ≥pT3b: p = 0.9). The NeuroSAFE-navigated patients reported a better 1-yr EF than non-NeuroSAFE (68% vs. 58%, p = 0.02) and no differences in 1-yr and 2-yr continence rates (92.4% vs. 91.8%, and 93.4% vs. 93%, respectively). The main limitation is the retrospective study design.
conclusionsWhile the NeuroSAFE approach did not show significant improvements in long-term oncologic or continence outcomes, it did provide an opportunity for a higher proportion of patients to improve postoperative functional results, possibly through increased nerve-sparing procedures.
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