title: Postoperative Leukocytosis After Robotic-Assisted Radical Prostatectomy Is Not Associated with Perioperative Outcome and Histopathological Findings.
abstract: BACKGROUND
  Recently a retrospective study has been published describing a significant correlation of immediate postoperative leukocytosis (IPLC) and a favorable pathological Gleason score (pGS) in patients undergoing robotic-assisted radical prostatectomy (RARP). The aim of the present study was to prospectively validate these results on an external dataset.
  
  
  METHODS
  In total, 346 patients undergoing RARP as first-line therapy for localized prostate cancer were included. Clinical and histopathological parameters, criteria of IPLC, and pGS were recorded prospectively. Potential association between IPLC and pGS was evaluated by univariate and multivariate analyses.
  
  
  RESULTS
  IPLC was found in 77.2% (n = 267) of all patients with a median leukocyte blood count (LBC) of 12.5 × 10(9)/L (interquartile range, 10.2-15 × 10(9)/L). Of these, in 255 patients IPLC was found within the range of 10-20 × 10(9)/L, whereas an IPLC of >20 × 10(9)/L was found in only 12 patients. Of the patients, 49.1%, 40.5%, and 10.4% presented with a pGS6, pGS7, and pGS8-10 tumor, respectively. There was neither a univariate nor a multivariate correlation between IPLC and pGS. Furthermore, no significant correlation could be detected between IPLC and other clinical, intraoperative, or histopathological criteria. In 175 (66%) patients with IPLC normal LBC levels were measured on postoperative Day 4.
  
  
  CONCLUSIONS
  IPLC was not associated with more favorable tumor biology (lower pGS, better tumor stage) and not influenced by patient conditions (age, body mass index, American Society of Anesthesiologists score, smoking) or intraoperative parameters (blood loss, operating time, surgeon). In addition, there was no significant correlation with serious complications (Clavien-Dindo Grade 3a/b) within a period of 90 days.
authors.affiliation: 1 Department of Urology, St. Elisabeth-Hospital Straubing , Straubing, Germany .
authors.forename: Amr
authors.initials: A
authors.lastname: Ahmed
authors.affiliation: 1 Department of Urology, St. Elisabeth-Hospital Straubing , Straubing, Germany .
authors.forename: Michael
authors.initials: M
authors.lastname: Eckerl
authors.affiliation: 2 Department of Urology, University of Regensburg , Caritas-Krankenhaus St. Josef, Regensburg, Germany .
authors.forename: Johannes
authors.initials: J
authors.lastname: Bründl
authors.affiliation: 1 Department of Urology, St. Elisabeth-Hospital Straubing , Straubing, Germany .
authors.forename: Julia
authors.initials: J
authors.lastname: Peter
authors.affiliation: 3 Department of Urology, Ruppiner Kliniken Neuruppin , Neuruppin, Germany .
authors.forename: Steffen
authors.initials: S
authors.lastname: Lebentrau
authors.affiliation: 4 Department of Urology, Ludwig-Maximilians-University of Munich , Munich, Germany .
authors.forename: Sabine
authors.initials: S
authors.lastname: Brookman-May
authors.affiliation: 2 Department of Urology, University of Regensburg , Caritas-Krankenhaus St. Josef, Regensburg, Germany .
authors.forename: Hans-Martin
authors.initials: HM
authors.lastname: Fritsche
authors.affiliation: 2 Department of Urology, University of Regensburg , Caritas-Krankenhaus St. Josef, Regensburg, Germany .
authors.forename: Maximilian
authors.initials: M
authors.lastname: Burger
authors.affiliation: 1 Department of Urology, St. Elisabeth-Hospital Straubing , Straubing, Germany .
authors.forename: Matthias
authors.initials: M
authors.lastname: May
authors.affiliation: 1 Department of Urology, St. Elisabeth-Hospital Straubing , Straubing, Germany .
authors.forename: Christian
authors.initials: C
authors.lastname: Gilfrich
mesh_terms: D000368:Aged; D006801:Humans; D007958:Leukocyte Count; D007964:Leukocytosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D061646:Operative Time; D011184:Postoperative Period; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000009:adverse effects*