title: Robot-assisted radical prostatectomy in patients with a pathologic prostate specimen weight ≥100 grams versus ≤50 grams: surgical, oncologic and short-term functional outcomes.
abstract: BACKGROUND
  The objective of this study is to evaluate the surgical, oncological and short-term functional outcomes in patients with a pathologic prostate specimen weight ≥100 g versus patients with a pathologic prostate specimen weight ≤50 g undergoing robot-assisted radical prostatectomy (RARP).
  
  
  METHODS
  The records of 4,000 men who underwent RARP from February 2006 to April 2012 were reviewed retrospectively. A total of 185 men had a pathologic prostate specimen weight ≥100 g (group A). A matched pairs analysis was performed using our database to identify men with a pathologic prostate specimen weight ≤50 g but with equivalent clinicopathologic characteristics to serve as the control group (group B).
  
  
  RESULTS
  Our results indicated that although the intraoperative results were more than satisfying in patients with large glands, there is a significant increase in blood loss, operative time needed, increased need for bladder neck reconstruction as well as an increase in intraoperative complications. Nevertheless, patients with large glands exhibit less aggressive tumors, less positive surgical margins and a lower incidence of biochemical recurrence. Regarding functional outcomes, patients with larger glands had no difference regarding continence rates when compared to patients with smaller glands but exhibited significantly lower potency rates.
  
  
  CONCLUSIONS
  Although RARP in patients with a pathologic prostate specimen weight ≥100 g is technically challenging, in experienced hands it can be considered a safe procedure with excellent surgical, oncological and functional outcomes. Nevertheless, this conclusion is limited, in that it is from a single institution with a large case volume and may not be reflective of outcomes at centers with smaller volumes and less experience.
authors.affiliation: Department of Urology and Pediatric Urology, Prostate Center Northwest, St. Antonius Hospital, Gronau, Germany. labanaris @ web.de
authors.forename: Apostolos P
authors.initials: AP
authors.lastname: Labanaris
authors.forename: Vahudin
authors.initials: V
authors.lastname: Zugor
authors.forename: Jorn H
authors.initials: JH
authors.lastname: Witt
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001706:Biopsy; D016063:Blood Loss, Surgical; D016009:Chi-Square Distribution; D007172:Erectile Dysfunction / Q000209:etiology; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011467:Prostate / Q000473:pathology / Q000601:surgery*; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012307:Risk Factors; D012371:Robotics; D013997:Time Factors; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery; D014549:Urinary Incontinence / Q000209:etiology