cad a22 4500 551468092 20190902071916.0 cr unu---uuuuu 181215e20190901xx s 000 0 eng 10.5167/uzh-159399 doi 10.1007/s00345-018-2578-y doi (ZORA)oai:www.zora.uzh.ch:159399 610 ddc 30519744 pmid Prognostic value of unifocal and multifocal positive surgical margins in a large series of robot-assisted radical prostatectomy for prostate cancer [Elektronische Daten] [Etienne Xavier Keller, Jacqueline Bachofner, Anna Jelena Britschgi, Karim Saba, Ashkan Mortezavi, Basil Kaufmann, Christian D Fankhauser, Peter Wild, Tullio Sulser, Thomas Hermanns, Daniel Eberli, Cédric Poyet] closedAccess eu-repo PURPOSE To evaluate the prognostic value of positive surgical margins (PSM) focality for the prediction of biochemical recurrence (BCR) in patients undergoing robotic-assisted radical prostatectomy (RARP) for prostate cancer. METHODS All men with clinically localized prostate cancer undergoing RARP in our tertiary referral centre between May 2005 and August 2016 were retrospectively identified. Patients with neoadjuvant therapy were excluded. Comparisons were made between cases with negative surgical margins (NSM), unifocal PSM (uPSM), and multifocal PSM (mPSM). RESULTS From a total of 973 patients available for analysis, 315 (32%) had a PSM. In these patients, 190 had uPSM and 125 had mPSM. Focality of PSM was significantly associated with tumour stage and grade, preoperative PSA, and postoperative PSA persistence (all p < 0.001), but not with nerve sparing (NS) (p = 0.15). PSA persistence was found in 120 (12%) patients, resulting in 853 patients available for survival analyses with a median follow-up of 52months. Both uPSM and mPSM were found to be independent predictors of BCR, conferring a hazard ratio of 1.9 (95% CI 1.3-3.0; p = 0.002) and 3.4 (95% CI 2.1-5.6; p < 0.001), respectively, when compared to NSM. In subgroup analyses, PSM was particularly predictive for BCR when patients underwent unilateral or bilateral NS (p ≤ 0.003). CONCLUSIONS Based on a large case series of RARP, we found PSM focality to be an independent predictor of BCR, with a 1.9- and 3.4-fold risk increase for BCR in case of uPSM and mPSM, respectively. PSM seems to be of particular prognostic relevance when NS has been performed. Institute of Pathology and Molecular Pathology zora Urological Clinic zora Keller Etienne Xavier joint author Bachofner Jacqueline joint author Britschgi Anna Jelena joint author Saba Karim joint author Mortezavi Ashkan joint author Kaufmann Basil joint author Fankhauser Christian D. joint author Wild Peter joint author Sulser Tullio joint author Hermanns Thomas joint author Eberli Daniel joint author Poyet Cédric joint author World Journal of Urology 37(9):1837-1844 https://www.zora.uzh.ch/id/eprint/159399/1/Keller2018_Article_PrognosticValueOfUnifocalAndMu.pdf text/html WWW-Backlink auf das Repository 1 Journal Article PeerReviewed zora ZORA 856 40 https://www.zora.uzh.ch/id/eprint/159399/1/Keller2018_Article_PrognosticValueOfUnifocalAndMu.pdf text/html WWW-Backlink auf das Repository ZORA 700 1- Keller Etienne Xavier joint author ZORA 700 1- Bachofner Jacqueline joint author ZORA 700 1- Britschgi Anna Jelena joint author ZORA 700 1- Saba Karim joint author ZORA 700 1- Mortezavi Ashkan joint author ZORA 700 1- Kaufmann Basil joint author ZORA 700 1- Fankhauser Christian D. joint author ZORA 700 1- Wild Peter joint author ZORA 700 1- Sulser Tullio joint author ZORA 700 1- Hermanns Thomas joint author ZORA 700 1- Eberli Daniel joint author ZORA 700 1- Poyet Cédric joint author ZORA 773 0- World Journal of Urology 37(9):1837-1844 BK010053 XK010053 XK010000 ZORA ZORA ZORA Journal Article closedAccess