Abstract
A common practice during robot-assisted radical prostatectomy (RARP) is to dissect the anterior prostate space and send this anterior fat sample for histological analysis to assess for the presence of any malignant tissue. Theoretically, this may help with prognostication and oncological control, however, is this a futile process? To determine the incidence of malignant tissue found in the anterior prostate (APF) samples sent for histological review. All RARP patients within a single urology centre over a 2-year period were included. The pathology results of these patients were reviewed and the proportion of patients with APF sent were analysed for presence of lymph nodes and malignant tissue. 657 patients were identified. 358 patients had APF samples reviewed by the histopathologists. 38 (10.6%) samples had lymph nodes identified within the sample. Malignant lymph node tissue was found in one patient (0.3%). Given the yield of malignancy found in APF samples is so small and the financial and time burden on pathology services, this process is not worthwhile.
Similar content being viewed by others
Code availability
Not applicable.
References
Urbanek C, Turpen R, Rosser CJ (2014) Radical prostatectomy: Hospital volumes and surgical volumes—does practice make perfect? BMC Surg 9:10
Special Commissioning Team (2015) B14/P/a robotic assisted surgery for prostate cancer. NHS England
Ploussard G, Briganti A, de la Taille A et al (2014) Pelvic lymph node dissection during robot-assisted radical prostatectomy: efficacy, limitations, and complications-a systematic review of the literature. Eur Urol 65(1):7–16
Dadgar H, Emami F, Norouzbeigi N, Vafaee MS, Jafari E, Gholamrezanezhad A, Assadi M, Ahmadzadehfar H (2020) Application of [68Ga]PSMA PET/CT in Diagnosis and Management of Prostate Cancer Patients. Mol Imaging Biol 22(4):1062–1069
Shimizu Y, Ogawa K, Kida K et al (2018) Lymph node metastasis to the prostatic anterior fat pad in the patients treated with prostatectomy. Hinyokika Kiyo 64(9):359–363
Ball MW, Harris KT, Schwen ZR et al (2017) Pathological analysis of the prostatic anterior fat pad at radical prostatectomy: insights from a prospective series. BJU Int 119(3):444–448
Aning JJ, Thurairaja R, Gillatt DA et al (2014) Pathological analysis of lymph nodes in anterior prostatic fat excised at robot-assisted radical prostatectomy. J Clin Pathol 67(9):787–791
Jeong J, Choi EY, Kang DI et al (2013) Pathologic implications of prostatic anterior fat pad. Urol Oncol 31(1):63–67
Finley DS, Deane L, Rodriguez E et al (2007) Anatomic excision of anterior prostatic fat at radical prostatectomy: implications for pathologic upstaging. Urology 70(5):1000–1003
Filby J, Nesbitt AL, Ravichandran K et al (2020) The impact of histopathological analysis of anterior peri-prostatic fat in radical prostatectomy patients. J Clin Urol 13(1):19–24
Lopez-Hisijos N, Genco I, Gorbonos A et al (2018) Metastatic involvement of the prostatic anterior fat pad: implications for the pathologist. Am J Clin Pathol 150(2):130–136
Hosny M, Rai B, Aljaafari F et al (2017) Can anterior prostatic fat harbor prostate cancer metastasis? A prospective cohort study. Curr Urol 10(4):182–185
Atmaca AF, Canda AE, Keske M et al (2015) Does anterior prostatic fat tissue removed during robotic radical prostatectomy contain any lymph nodes? Cent Eur J Urol 68(4):410–414
Kim IY, Modi PK, Sadimin E, Ha YS, Kim JH, Skarecky D, Cha DY, Ou YC, Park S, Albala DM, Wilson T, Ahlering T, Badani K, Ahn H, Lee DI, Kim WJ, Lee DH (2013) Detailed analysis of prostate cancer patients with metastasis to the prostate anterior fat pad lymph nodes: a multi-institutional study. J Urol 190:527
Acknowledgements
Thank you to all staff at The Stokes Centre of Urology, especially those that keep the prostatectomy database concise and up to date and to the RSCH pathology department for consulting on this project.
Funding
Not applicable.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Alexandra Guy, Liam Kavanagh, Edward Hart, Ban Haagsma and Matthew Perry declare that they have no conflict of interest.
Ethics approval
Ethical approval was not required in accordance with local trust guidance on retrospective studies.
Consent to participate
Not applicable.
Consent for publication
Not applicable.
Availability of data and material
All data were available on trust computers and pathology systems from previously collected information and samples.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Guy, A.M., Kavanagh, L.E., Hart, E. et al. Anterior prostate fat resection during prostatectomy: a histopathologic review. J Robotic Surg 15, 769–772 (2021). https://doi.org/10.1007/s11701-020-01172-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11701-020-01172-6