title: Incidence of positive surgical margins after robotic assisted radical prostatectomy: Does the surgeon's experience have an influence on all pathological stages?
abstract: OBJECTIVE
  The aim of this study is to analyze the clinical and surgical features of patients who underwent robotic-assisted radical prostatectomy (RARP) at our institution, and the impact of the surgeon's experience in the oncological results related to pathological stage.
  
  
  METHODS
  An analysis of 300 RARP consecutively performed by the same urologist was conducted. Patients were divided into 3 groups of 100 patients in chronological order, according to surgery date. All patients had organ-confined clinical stage. Variables which could impact in positive margins rates were analyzed. Finally, positive surgical margins (PSM) in regard to pathological stage and surgeon's experience were compared and analyzed.
  
  
  RESULTS
  No significant differences were found in variables which could impact in PSM rates. The overall PSM rate was 21%, with 28% in the first group, 20% in the second, and 16% in the third (P = .108). Significant lineal decreasing tendency was observed (P = .024). In pT2 patients, the overall PSM rate was 16.6%, with 27%, 13.8%, and 7.3% in each group respectively (P = .009). A significant difference was found between group 1 and group 3 (P = .004). In pT3 patients, the surgeon's experience was not significantly associated with margin reductions with an overall PSM rate of 27.7% (28.2%, 28.6%, and 26.7% in each group respectively).
  
  
  CONCLUSIONS
  Clinical and surgical features in our patients did not vary over time. We found a significant reduction of PSM related to surgeon's experience in pT2 patients. Contrariwise, the margin status remained stable despite increasing experience in pT3 patients.
authors.affiliation: Departamento de Urología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: A W
authors.initials: AW
authors.lastname: Villamil
authors.affiliation: Departamento de Urología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: J I
authors.initials: JI
authors.lastname: Costabel
authors.affiliation: Departamento de Urología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Electronic address: nicolas.billordo@hiba.org.ar.
authors.forename: N
authors.initials: N
authors.lastname: Billordo Peres
authors.affiliation: Departamento de Urología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: P F
authors.initials: PF
authors.lastname: Martínez
authors.affiliation: Departamento de Urología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: C R
authors.initials: CR
authors.lastname: Giudice
authors.affiliation: Departamento de Urología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: O H
authors.initials: OH
authors.lastname: Damia
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011467:Prostate / Q000473:pathology* / Q000601:surgery*; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D065287:Robotic Surgical Procedures
keywords: Curva de aprendizaje; Cáncer de próstata; Learning curve; Márgenes quirúrgicos positivos; Positive surgical margins; Prostate cancer; Prostatectomía radical asistida con tecnología robótica; Robotic-assisted radical prostatectomy