Long-term experience with an anatomical anterograde approach to radical prostatectomy: Results in terms of positive margin rate

Purpose: To evaluate the effect of an anterograde approach to radical retropubic prostatectomy ( RRP) in terms of positive surgical margins ( SM+). Methods: 323 untreated patients underwent anterograde RRP for clinically localized prostate adenocarcinoma. Spearman coefficients, logistic univariate and multivariate analysis were used. Results: The incidence of SM+ was 14.9% and, in particular, this was 4.5% for apical, 9.0% for lateral, 0.9% for other sites, and 2.8% for multiple SM+. Upon univariate analysis, prostate- specific antigen ( PSA; r = 0.2073, p = 0.0002), pathological stage ( r = 0.3777, p < 0.0001), and seminal vesicle invasion ( r = 0.1453, p = 0.0089) were found to be significantly associated with SM+. Upon multivariate analysis, only PSA ( p = 0.0090) and pathological stage ( p ! 0.0001) were significantly and independently associated with SM+ occurrence. Conclusion: In our experience, the anterograde approach to RRP is associated with low SM+ rates. Copyright (C) 2008 S. Karger AG, Basel.