Long-term experience with an anatomical anterograde approach to radical prostatectomy: results in terms of positive margin rate.
OBJECTIVE
To evaluate the effect of an anterograde approach to radical retropubic prostatectomy (RRP) in terms of positive surgical margins (SM+).


METHODS
323 untreated patients underwent anterograde RRP for clinically localized prostate adenocarcinoma. Spearman coefficients, logistic univariate and multivariate analysis were used.


RESULTS
The incidence of SM+ was 14.9% and, in particular, this was 4.5% for apical, 9.0% for lateral, 0.9% for other sites, and 2.8% for multiple SM+. Upon univariate analysis, prostate-specific antigen (PSA; r = 0.2073, p = 0.0002), pathological stage (r = 0.3777, p < 0.0001), and seminal vesicle invasion (r = 0.1453, p = 0.0089) were found to be significantly associated with SM+. Upon multivariate analysis, only PSA (p = 0.0090) and pathological stage (p < 0.0001) were significantly and independently associated with SM+ occurrence.


CONCLUSIONS
In our experience, the anterograde approach to RRP is associated with low SM+ rates.
Sciarra
Alessandro
A
Department Urology, University La Sapienza, Rome, Italy. sciarrajr@hotmail.com
Gentile
Vincenzo
V
De Matteis
Anna
A
Dattilo
Cristian
C
Autran Gomez
Anna-Maria
AM
Salciccia
Stefano
S
Di Silverio
Franco
F
D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery*; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors