Cancer Res Treat.  2009 Dec;41(4):205-210.

Biopsy Related Prostate Status Does Not Affect on the Clinicopathological Outcome of Robotic Assisted Laparoscopic Radical Prostatectomy

Affiliations
  • 1Department of Urology, MIS & Robotic Urologic Surgery Center, Korea University School of Medicine, Seoul, Korea. urokyh@naver.com
  • 2Global Robotics Institute, University of Central Florida, Florida Hospital, Orlando, FL, USA.

Abstract

PURPOSE
To determine whether the biopsy core number and time interval between prostate biopsy and radical prostatectomy affect the operative and oncologic outcome of robot assisted laparoscopic radical prostatectomy (RALP). MATERIALS AND METHODS: From January 2008 to April 2009, a single surgeon performed 72 RALPs after an initial learning period of 30 cases. The relationship between time from biopsy to prostatectomy and biopsy core number with operative time and estimated blood loss (EBL) were initially evaluated with a linear regression model. These patients were classified into groups according to whether the interval from biopsy to RALP was within four weeks or not, and whether there were less than or greater than 10 core specimens removed. RESULTS: RALP was performed in 34 patients within four weeks of biopsy, and in 38 patients more than 4 weeks after biopsy. According to the number of core specimens removed, less than 10 cores were performed in 10 patients, and more than 10 cores were performed in 62 patients. Using an interval of 4 weeks as the cutoff point, early surgery was associated with longer operating time (232.6 vs 208.8 min) and increased estimated blood loss (305.1 vs 276.9 mL). For cases with more than 10 biopsy cores, there was a slight increase in operative time (229.2 vs 210.3 min). None of these differences were statistically significant by multivariate analysis. CONCLUSION: Our data suggests that there is no reason to delay RALP to more than 4 weeks after prostate biopsy. It also revealed that the number of biopsy cores (up to 14) did not influence operative outcome. Thus, RALP is a feasible procedure regardless of the biopsy related prostate state.

Keyword

Prostate biopsy; Robotics; Radical prostatectomy

MeSH Terms

Biopsy
Humans
Learning
Linear Models
Multivariate Analysis
Operative Time
Prostate
Prostatectomy
Robotics

Figure

  • Fig. 1 (A) Simple correlation analysis between interval from biopsy to RALP (weeks) and operative time (minute) (correlation coefficient 0.24, p=0.09), (B) between interval from biopsy to RALP (weeks) and EBL (mL) (correlation coefficient 0.26, p=0.14).

  • Fig. 2 (A) Simple correlation analysis between total number of tissue cores removed from biopsy and operative time (minute) (correlation coefficient 0.10, p=0.35) , (B) between total number of tissue cores removed from biopsy and EBL (mL) (correlation coefficient 0.09, p=0.53).


Reference

1. Joseph JV, Vicente I, Madeb R, Erturk E, Patel HR. Robot-assisted vs pure laparoscopic radical prostatectomy: are there any differences? BJU Int. 2005; 96:39–42. PMID: 15963117.
Article
2. Nelson JB. Debate: Open radical prostatectomy vs. laparoscopic vs. robotic. Urol Oncol. 2007; 25:490–493. PMID: 18047958.
Article
3. Sokoloff MH, Brendler CB. Indications and contraindications for nerve-sparing radical prostatectomy. Urol Clin North Am. 2001; 28:535–543. PMID: 11590812.
Article
4. Menon M, Tewari A, Peabody JO, Shrivastava A, Kaul S, Bhandari A, et al. Vattikuti Institute prostatectomy, a technique of robotic radical prostatectomy for management of localized carcinoma of the prostate: experience of over 1100 cases. Urol Clin North Am. 2004; 31:701–717. PMID: 15474597.
Article
5. Ban JH, Ko YH, Kang SH, Park HS, Cheon J. Learning curve with robotic-assisted laparoscopic radical prostatectomy: a prospective study. Korean J Urol. 2009; 50:140–147.
Article
6. Beahrs OH, Henson DE, Hutter RVP, Kennedy BJ. American Joint Committee on Cancer. Manual for staging of cancer. 1992. 4th ed. Philadelphia: JB Lippincott;p. 239.
7. Patel VR. Robotic Urologic Surgery. 2007. 1st ed. London: Springer;p. 81.
8. Stolzenburg JU, Anderson C, Rabenalt R, Do M, Ho K, Truss MC. Endoscopic extraperitoneal radical prostatectomy in patients with prostate cancer and previous laparoscopic inguinal mesh placement for hernia repair. World J Urol. 2005; 23:295–299. PMID: 16133559.
Article
9. Kaji Y, Kurhanewicz J, Hricak H, Sokolov DL, Huang LR, Nelson SJ, et al. Localizing prostate cancer in the presence of postbiopsy changes on MR images: role of proton MR spectroscopic imaging. Radiology. 1998; 206:785–790. PMID: 9494502.
Article
10. Oesterling JE, Rice DC, Glenski WJ, Bergstralh EJ. Effect of cystoscopy, prostate biopsy, and transurethral resection of prostate on serum prostate-specific antigen concentration. Urology. 1993; 42:276–282. PMID: 7691013.
Article
11. Lee DK, Allareddy V, O'donnell MA, Williams RD, Konety BR. Does the interval between prostate biopsy and radical prostatectomy affect the immediate postoperative outcome? BJU Int. 2006; 97:48–50. PMID: 16336327.
Article
12. Eggener SE, Yossepowitch O, Serio AM, Vickers AJ, Scardino PT, Eastham JA. Radical prostatectomy shortly after prostate biopsy does not affect operative difficulty or efficacy. Urology. 2007; 69:1128–1133. PMID: 17572200.
Article
13. Singh A, Fagin R, Shah G, Shekarriz B. Impact of prostate size and body mass index on perioperative morbidity after laparoscopic radical prostatectomy. J Urol. 2005; 173:552–554. PMID: 15643251.
Article
14. Hsu EI, Hong EK, Lepor H. Influence of body weight and prostate volume on intraoperative, perioperative, and postoperative outcomes after radical retropubic prostatectomy. Urology. 2003; 61:601–606. PMID: 12639655.
Article
15. Boorjian SA, Bianco FJ Jr, Scardino PT, Eastham JA. Does the time from biopsy to surgery affect biochemical recurrence after radical prostatectomy? BJU Int. 2005; 96:773–776. PMID: 16153197.
16. Khan MA, Mangold LA, Epstein JI, et al. Impact of surgical delay on long-term cancer control for clinically localized prostate cancer. J Urol. 2004; 172:1835–1839. PMID: 15540733.
Article
17. Presti JC Jr, Chang JJ, Bhargava V, Shinohara K. The optimal systematic prostate biopsy scheme should include 8 rather than 6 biopsies: results of a prospective clinical trial. J Urol. 2000; 163:163–166. PMID: 10604337.
Article
18. Gore JL, Shariat SF, Miles BJ, Kadmon D, Jiang N, Wheeler TM, et al. Optimal combinations of systematic sextant and laterally directed biopsies for the detection of prostate cancer. J Urol. 2001; 165:1554–1559. PMID: 11342916.
Article
19. Berger AP, Gozzi C, Steiner H, Frauscher F, Varkarakis J, Rogatsch H, et al. Complication rate of transrectal ultrasound guided prostate biopsy: a comparison among 3 protocols with 6, 10 and 15 cores. J Urol. 2004; 171:1478–1480. PMID: 15017202.
Article
20. Shah JB, McKiernan JM, Elkin EP, Carroll PR, Meng MV. CaPSURE Investigators. Prostate biopsy patterns in the CaPSURE database: evolution with time and impact on outcome after prostatectomy. J Urol. 2008; 179:136–140. PMID: 17997437.
Article
Full Text Links
  • CRT
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr