Does intraoperative frozen section really predict significant positive surgical margins after robot-assisted laparoscopic prostatectomy?A retrospective study

作     者：Se Young Choi Byung Hoon Chi Tae-Hyoung Kim Bumjin Lim Wonchul Lee Dalsan You Choung-Soo Kim Se Young Choi;Byung Hoon Chi;Tae-Hyoung Kim;Bumjin Lim;Wonchul Lee;Dalsan You;Choung-Soo Kim

作者机构：Department of UrologyChung-Ang University HospitalChung-Ang University College of MedicineDongjak-guSeoul 06973Korea Department of UrologyAsan Medical CenterUniversity of Ulsan College of MedicineSongpa-guSeoul 05505Korea 

出 版 物：《Asian Journal of Andrology》 (亚洲男性学杂志（英文版）)

年 卷 期：2021年第23卷第1期

页      面：74-79页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：This research was supported by the Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Science,ICT&Future Planning(NRF-2019R1C1C1005170) Korea Health Technology R&D Project,the Korea Health Industry Development Institute(H16C2193) 

主　　题：biochemical recurrence frozen section positive surgical margin robotic-assisted prostatectomy 

摘      要：We investigated the relationship between positive surgical margin(PSM)-related factors and biochemical recurrence(BCR)and the ability of intraoperative frozen sections to predict significant PSM in patients with prostate *** study included 271 patients who underwent robot-assisted laparoscopic prostatectomy with bilateral nerve sparing and maximal urethral *** frozen sections of the periurethra,dorsal vein,and bladder neck were *** ability of PSM-related factors to predict BCR and significant PSM was assessed by logistic *** 271 patients,108(39.9%)had PSM and 163(60.1%)had negative *** Gleason score^8(18.9%vs 7.5%,P=0.015)and T stage≥T3a(51.9%vs 24.6%,P0.001)were significantly more frequent in the PSM *** analysis showed that Gleason pattern≥4(vs4;hazard ratio:4.386;P=0.0004)was the only significant predictor of BCR in the PSM *** frozen sections had a sensitivity of 83.3%and a specificity of 84.2%in detecting PSM with Gleason pattern≥*** analysis showed that membranous urethra length(odds ratio[OR]:0.79,P=0.0376)and extracapsular extension of the apex(OR:4.58,P=0.0226)on magnetic resonance imaging(MRI)and positive periurethral tissue(OR:17.85,P0.0001)were associated with PSM of the *** with Gleason pattern≥4 is significantly predictive of *** frozen sections of periurethral tissue can independently predict PSM,whereas sections of the bladder neck and dorsal vein could *** examination of these samples may help predict significant PSM in patients undergoing robot-assisted laparoscopic prostatectomy with preservation of functional outcomes.