[Complete perineal prostatectomy carries an increased risk of capsular incision in healthy and cancerous tissue].
OBJECTIVE
To compare positive resection margin rates in tumour tissue and healthy tissue according to whether total prostatectomy for cancer is performed via a retropubic or transperineal approach.


METHODS
This retrospective, non-randomized study was based on 94 patients suffering from clinically localized cancer (T1-T2) of the prostate operated either via a retropubic (46: group 1) or perineal (48: group II) approach. All slides were reviewed by two pathologists not informed about the clinical course. The frequency of tumour margins associated with extracapsular invasion, capsular incision, without extracapsular extension of the tumour, and finally the incidence of capsular incisions exposing tumour tissue, were determined.


RESULTS
While the number of positive resection margins was equivalent in the two groups (61% for group I versus 56% for group II), it was higher in the perineal group (43% versus 29%, p < 0.05) when the tumour was confined to the gland (pT2). A higher incidence of resection margins in healthy tissue was also observed in group II (90% versus 37%).


CONCLUSIONS
Transperitoneal prostatectomy is associated with a higher incidence of resection margins in tumour tissue in patients with prostate-confined cancer. Analysis of the resection margins in healthy tissue suggests that the surgical incision is a predisposing factor to their creation.
Vordos
D
D
Service d'Urologie, Hôpital Bichat, Paris, France.
Ravery
V
V
Toublanc
M
M
Boccon-Gibod
L
L
Delmas
V
V
Boccon-Gibod
L
L
D000368:Aged; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010502:Perineum / Q000601:surgery; D011379:Prognosis; D011467:Prostate / Q000473:pathology*; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors
La prostatectomie totale périnéale expose à un risque accru d'incision capsulaire en tissu sain et tumoral.