Positive surgical margins at radical prostatectomy: importance of intra-operative bladder neck frozen sections.
OBJECTIVE
To determine if intraoperative frozen sections of the bladder neck during radical prostatectomy (RP) could decrease the incidence of final positive surgical margins at the bladder neck.


METHODS
This prospective cohort study included 51 consecutive men who underwent anatomic RP at University of Florida & Shands Jacksonville. All patients had intraoperative frozen section of bladder neck sent for analysis. Preoperative, operative, and postoperative data were collected and analyzed.


METHODS
Outcome measures were intraoperative bladder neck margin status, final pathologic bladder neck margin status, and postoperative urinary complications. Median follow-up for the 51 patients was 22 months.


RESULTS
The final positive surgical margin rate was 20% (10 patients). An additional three patients had positive surgical margins at the bladder neck intraoperatively. These patients then had a wider resection of the affected bladder neck until the frozen sections were negative for cancer or prostatic tissue. Final pathologic evaluation of bladder neck margin was negative for tumor or persistent prostatic tissue in all 51 men.


CONCLUSIONS
With intra-operative frozen sections, we were able to obtain a negligible positive bladder neck margin rate. Surgeons who are still on the learning curve for RP should consider intra-operative frozen section of the bladder neck.
Nakamura
Kogenta
K
Department of Urology, University of Florida, Gainesville, FL 32610, USA.
Kasraeian
Ali
A
Anai
Satoshi
S
Pendleton
John
J
Rosser
Charles J
CJ
D000368:Aged; D005500:Follow-Up Studies; D005629:Frozen Sections; D006801:Humans; D007430:Intraoperative Care; D010535:Laparoscopy; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010388:Pelvis / Q000473:pathology; D011184:Postoperative Period; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology* / Q000601:surgery; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D001743:Urinary Bladder / Q000473:pathology* / Q000601:surgery
D017430:Prostate-Specific Antigen