Objectives. To compare the pathologic evaluation of 60 sequential laparoscopic radical prostatectomy (LRP) specimens with 60 sequential and 60 stage and grade-matched open radical retropubic prostatectomy (RRP) cohort specimens. Methods. Of 68 patients undergoing LRP, 3 requiring open conversion and 5 receiving neoadjuvant hormonal therapy were excluded, leaving 60 for analysis. Among 72 sequential open RRP specimens, 60 from patients not receiving neoadjuvant hormonal therapy and without nodal metastases were analyzed. A third cohort of 60 RRP specimens matched with the LRP specimens for clinical stage and biopsy grade was also evaluated. Results. The specimen weight and preoperative serum prostate-specific antigen level were similar for each cohort, and approximately 75% of patients from each cohort were clinical Stage T1c. Forty-six LRP and matched open RRP (76.7%) and 39 sequential open RRP (65%) specimens were biopsy Gleason sum 6, and the remainder were primarily Gleason sum 7. The pathologic grade and stage distribution were similar for each cohort. Ten LRP (16.9%) and 12 open RRP (20%) specimens from each cohort had positive inked margins (P > 0.10). Positive apex margins were noted in 3, 7, and 7 and multiple positive margin sites in 0, 5, and 6 of the LRP, matched open RRP, and sequential open RRP specimens (P < 0.05), respectively. Conclusions. Pathologic evaluation of the LRP and open RRP specimens from patients not receiving neoadjuvant hormonal therapy demonstrated similar overall positive margin rates, but LRP had a lower rate of apex and multiple-site positive margins.
|Number of pages||6|
|State||Published - Sep 1 2003|
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