2008 Annual Meeting Abstracts

---

Anatomic Localization Of Positive Surgical Margins Following Robot Assisted Radical Prostatectomy
Douglas E Sutherland, M. Katayoon Rezaei*, Arnold M. Schwartz*, Harold A. Frazier, II, Jason D. Engel, Mark Hong*, Nikki Mourtzinos, Brian J Linder*, Fernando J Bianco, Jr.
George Washington University, Washington, DC

Introduction: The incidence of positive surgical margins (PSM) following open prostatectomy has been previously reported with varying prognostic implications PSM location.We attempt to characterize PSMs by their anatomic location following robot-assisted laparoscopic radical prostatectomy (RALRP).
Methods: All patients treated between 2004 and 20007 were considered. Specimens with a PSM were reviewed pathologically to determine its anatomic location and foci of extraprostatic extentension (EPE). All EPE and PSMs were localized as anterior or posteriolateral. An anterior designation was given when the PSM or EPE occurred above an imaginary line connecting the 3 and 9 o’clock positions; a posteriolateral designation was given for a PSM or EPE below the same line. Chi squared testing was applied.
Results: 568 patients were considered. The median age for the cohort was 59.9. The median PSA was 5.4 and 81% were clinical stage T1c. The proportion of patients with biopsy Gleason scores of <6, 7, and >8 were 67%, 24%, and 8%, respectively. Eighty one percent were found to be pT2 and 87% demonstrated tumor multifocality. EPE was indentified in 77 patients (14%), seminal vesicle invasion in 27 (5%). A PSM was found in 116 patients (20%), and 41% were multifocal. Of those with a PSM, 66% had an anterior PSM and 71% had a posteriolateral PSM. The incidence of PSM was significantly related to pathologic stage overall (18% for pT2 compared to 32% for pT3, p=0.001).
Conclusions: Anterior and posteriolateral PSMs had a nearly equal incidence after RALRP, which is different than reported following RRP.

---