title: Pathologic comparison of laparoscopic versus open radical retropubic prostatectomy specimens.
abstract: OBJECTIVE
  To compare the pathologic evaluation of 60 sequential laparoscopic radical prostatectomy (LRP) specimens with 60 sequential and 60 stage and grade-matched open radical retropubic prostatectomy (RRP) cohort specimens.
  
  
  METHODS
  Of 68 patients undergoing LRP, 3 requiring open conversion and 5 receiving neoadjuvant hormonal therapy were excluded, leaving 60 for analysis. Among 72 sequential open RRP specimens, 60 from patients not receiving neoadjuvant hormonal therapy and without nodal metastases were analyzed. A third cohort of 60 RRP specimens matched with the LRP specimens for clinical stage and biopsy grade was also evaluated.
  
  
  RESULTS
  The specimen weight and preoperative serum prostate-specific antigen level were similar for each cohort, and approximately 75% of patients from each cohort were clinical Stage T1c. Forty-six LRP and matched open RRP (76.7%) and 39 sequential open RRP (65%) specimens were biopsy Gleason sum 6, and the remainder were primarily Gleason sum 7. The pathologic grade and stage distribution were similar for each cohort. Ten LRP (16.9%) and 12 open RRP (20%) specimens from each cohort had positive inked margins (P > 0.10). Positive apex margins were noted in 3, 7, and 7 and multiple positive margin sites in 0, 5, and 6 of the LRP, matched open RRP, and sequential open RRP specimens (P < 0.05), respectively.
  
  
  CONCLUSIONS
  Pathologic evaluation of the LRP and open RRP specimens from patients not receiving neoadjuvant hormonal therapy demonstrated similar overall positive margin rates, but LRP had a lower rate of apex and multiple-site positive margins.
authors.affiliation: Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors.forename: James A
authors.initials: JA
authors.lastname: Brown
authors.forename: Christopher
authors.initials: C
authors.lastname: Garlitz
authors.forename: Leonard G
authors.initials: LG
authors.lastname: Gomella
authors.forename: Scott G
authors.initials: SG
authors.lastname: Hubosky
authors.forename: Stuart M
authors.initials: SM
authors.lastname: Diamond
authors.forename: David
authors.initials: D
authors.lastname: McGinnis
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Strup
mesh_terms: D001707:Biopsy, Needle; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009929:Organ Size; D011467:Prostate / Q000473:pathology; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome