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67th Annual Meeting Abstracts
A Multi-institutional Comparison of Radical Retropubic Prostatectomy, Radical Perineal Prostatectomy, and Robotic Assisted Laparoscopic Prostatectomy for the Treatment of Localized Prostate Cancer
*Eric E Coronato1, *Justin D. Harmon2, *Phillip C. Ginsberg3, Richard C. Harkaway3, *Kulwant Singh1, *Samit Patel1, *Leonard Braitman3, Bruce B Sloane2, *Jamison S Jaffe2
1Philadelphia College of Osteopathic Medicine, Philadelphia, PA;2Hahnemann University Hospital, Philadelphia, PA;3Albert Einstein Medical Center, Philadelphia, PA
Introduction: To evaluate the pathological stage and margin status of patients undergoing radical retropubic prostatectomy (RRP), radical perineal prostatectomy (RPP) and robotic assisted laparoscopic prostatectomy (RALP).
Materials & Methods: We performed a retrospective analysis of 196 patients who underwent RRP, RPP and RALP as part of our multi-institution program. 57 patients underwent RRP, 41 RPP, and 98 RALP. Patient age, preoperative PSA, preoperative Gleason score, preoperative clinical stage, pathological stage, postoperative Gleason score, and margin status were reviewed.
Results: All preoperative factors except for PSA were similar. Margins were positive in 12%, 24%, and 36% of patients from RALP, RRP, and RPP (p=0.004). The positive margin rates in patients with pT2 tumors were 4%, 14%, and 19% in the RALP, RRP, and the RPP groups (p=0.03). Controlling for age and pre-operative PSA and Gleason score, the rate of positive margins was statistically lower in the RALP vs. both the RRP (p=0.046) and the RPP groups (p=0.02). In the patients with pT3 tumors, positive margins were observed in 36% of patients undergoing the RALP and 53% and 90% of patients undergoing the RRP and RPP (p=0.015). Controlling for the same factors, the positive margin rate was statistically lower in the RALP vs. the RPP (p=0.01) but not compared to the RRP patients (p=0.32).
Conclusions: The percentage of positive margins was lower in RALP than in RPP for both pT2 and pT3 tumors. RRP had a higher percentage of positive margins than RALP among pT2 tumors but not for pT3 tumors.
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