title: Impact of Partin nomogram on presurgical planning: intrafascial versus interfascial nerve sparing during robot-assisted radical prostatectomy.
abstract: We studied the impact of using the Partin nomogram in tailoring the nerve sparing approach during robot-assisted radical prostatectomy. From July 2008 to July 2009, 168 patients underwent robot-assisted radical prostatectomy with bilateral nerves spared. All of the first 70 patients (cohort I) had intrafascial nerve sparing, while the Partin nomogram was used to determine the nerve sparing approach in the next 98 patients (cohort II). In patients with a probability greater than 53% of having pathologically non-organ-confined disease, conventional interfascial nerve sparing was performed; otherwise, intrafascial nerve sparing was carried out. Preoperative patient demographics were similar between the two cohorts. In cohort II, 68 and 30 patients had the bilateral nerves spared intrafascially and interfascially, respectively. Overall, the prevalence of pT3 disease in cohort I was 24.3% and in cohort II was 21.4%. The positive surgical margin rate in cohort I was 15.7% while that in cohort II was 6.1%. There was no significant difference in positive surgical margin rate in organ-confined (pT2) disease between the two groups (7.5 and 5.2%). On the other hand, pT3 positive surgical margin rate was significantly reduced in cohort II (41.2 and 4.8%, P = 0.013). Using the Partin nomogram in deciding interfascial versus intrafascial nerve sparing during robot-assisted radical prostatectomy gave a significant reduction of positive surgical margin rate in pT3 prostate cancers.
authors.affiliation: Section of Urologic Oncology and Dean and Betty Gallo Prostate Cancer Center, The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, 195 Little Albany Street, #4560, New Brunswick, NJ, 08903, USA.
authors.forename: Jeongyun
authors.initials: J
authors.lastname: Jeong
authors.affiliation: Section of Urologic Oncology and Dean and Betty Gallo Prostate Cancer Center, The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, 195 Little Albany Street, #4560, New Brunswick, NJ, 08903, USA.
authors.forename: Eun Yong
authors.initials: EY
authors.lastname: Choi
authors.affiliation: Section of Urologic Oncology and Dean and Betty Gallo Prostate Cancer Center, The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, 195 Little Albany Street, #4560, New Brunswick, NJ, 08903, USA.|Department of Urology, Inje University Medical School, Busan, Korea.
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Kang
authors.affiliation: Department of Urology, Ewha Womans University, Seoul, Korea.
authors.forename: Dong-Hyeon
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Section of Urologic Oncology and Dean and Betty Gallo Prostate Cancer Center, The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, 195 Little Albany Street, #4560, New Brunswick, NJ, 08903, USA. kimiy@umdnj.edu.
authors.forename: Isaac Yi
authors.initials: IY
authors.lastname: Kim
keywords: Partin nomogram; Prostatic neoplasm; Radical prostatectomy; Surgical margin