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Assessment of low prostate weight as a determinant of a higher positive margin rate after laparoscopic radical prostatectomy: a prospective pathologic study of 1,500 cases

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Abstract

Background

The assessment of prostate weight as a determinant of a high prostate margin rate after laparoscopic radical prostatectomy has not been studied.

Methods

Prospective pathologic findings of 1,500 patients who underwent laparoscopic radical prostatectomy (LRP, 399 cases) and da VinciTM prostatectomy (DVP, 1,101 cases) between December 2000 to June 2006 at City of Hope National Medical Center were evaluated. Gleason score, pathologic stage, the presence or absence of positive margins, extraprostatic tumor extension, and seminal vesicle involvement by tumor were recorded in all patients. Preoperational serum prostate specific antigen (PSA) levels were recorded in all but 13 cases. These parameters were then correlated with prostate weight.

Results

Of 1,500 patients, 345 had one or more positive margins (23%). Patients with low median prostate weight (49 g) had a significantly higher positive margin rate (p < 0.0001) and incidence of extraprostatic extension by tumor (p = 0.04), and were 1.523 times more likely to have positive margins [95% confidence interval (CI) 1.167–1.985].

Conclusion

We conclude that low prostate weight may be a determinant of a higher recurrence rate and more aggressive disease.

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Authors and Affiliations

  1. Division of Pathology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA, 91010, USA

    Peiguo G. Chu, Sean K. Lau & Lawrence M. Weiss

  2. Division of Surgery, City of Hope National Medical Center, Duarte, CA, USA

    Mark Kawachi, Jeffrey Yoshida, Laura Crocitto & Timothy Wilson

  3. Division of Information Sciences, City of Hope National Medical Center, Duarte, CA, USA

    Christopher Ruel & Rebecca Nelson

Authors
  1. Peiguo G. Chu
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  2. Sean K. Lau
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  3. Lawrence M. Weiss
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  4. Mark Kawachi
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  5. Jeffrey Yoshida
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  6. Christopher Ruel
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  7. Rebecca Nelson
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  8. Laura Crocitto
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  9. Timothy Wilson
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Correspondence to Peiguo G. Chu.

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Chu, P.G., Lau, S.K., Weiss, L.M. et al. Assessment of low prostate weight as a determinant of a higher positive margin rate after laparoscopic radical prostatectomy: a prospective pathologic study of 1,500 cases. Surg Endosc 23, 1058–1064 (2009). https://doi.org/10.1007/s00464-008-0131-6

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  • DOI: https://doi.org/10.1007/s00464-008-0131-6

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