1469 PHOTODYNAMIC DIAGNOSIS OF SURGICAL MARGIN DURING ENDOSCOPIC EXTRAPERITONEOSCOPIC RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized VII1 Apr 20121469 PHOTODYNAMIC DIAGNOSIS OF SURGICAL MARGIN DURING ENDOSCOPIC EXTRAPERITONEOSCOPIC RADICAL PROSTATECTOMY Chernyshov Igor, Kamil Kallaev, Denis Altunin, Alexei Jernov, and Iskander Abdullin Chernyshov IgorChernyshov Igor Moscow, Russian Federation More articles by this author , Kamil KallaevKamil Kallaev Moscow, Russian Federation More articles by this author , Denis AltuninDenis Altunin Moscow, Russian Federation More articles by this author , Alexei JernovAlexei Jernov Moscow, Russian Federation More articles by this author , and Iskander AbdullinIskander Abdullin Moscow, Russian Federation More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1990AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Radical prostatectomy is “gold standard” of localized prostate cancer (PC) treatment. Oncological and functional results of extraperitoneoscopic radical prostatectomy (EERPE) are proved to be similar to open and robotic-assisted procedures. Positive surgical margin (PSM) after EERPE is significant risk factor of disease recurrence. The opportunity of precise visualization of tumor extension could provide lower incidence of PSM. It has been already proved that photodynamic diagnosis (PDD) with fluorescent marker aminolevulinic acid can illuminate cancer tissue. The objective of this study was to evaluate results of PDD of tumor extension during EERPE. METHODS Inclusion criteria: patients with histologically proven PC, indications for EERPE. Exclusion criteria: renal or liver insufficiency, history of porphyries. All patients received aminolevulinic acid in dose of 1500 mg per os 3 hours before the procedure. After the resection of the prostate-seminal vesicles complex the organ bed, posterior urethra and bladder neck were illuminated with blue light. The focuses of red fluorescence were considered as PDD-positive areas. From the PDD-positive areas additional specimens for histological evaluation were biopsied. For PDD we used the equipment of Karl Storz D-Light C system. RESULTS From January 2010 till December 2010 a total amount of 15 patients fit inclusion/exclusion criteria were enrolled in study, mean age was 61,8±5,1 years, mean PSA 8,9±3,14 ng/ml, Gleason score 5-8. Tumor stage distributed: T1c - 3, T2a - 4, T2b - 4, T2c - 2, T3a - 1, T3b - 1 patients. In total we find PDD-positive areas in 5 (33%) patients, in 4 (26%) the PSM was proved histologically. We obtained false positive results in 1 (7%) patients. No false negative results were obtained. Sensitivity of technique was 100%, specificity - 90%. No side effects of PDD during surgery and post-operating period were registered. CONCLUSIONS Absence of PSM is one of important criteria of perfect RP and it is included in pentafecta variables. PDD with aminolevulinic acid during EERPE is effective and safe method for reducing of incidence of PSM. Further development of this technique can improve the results of surgical treatment of localized PC. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e596 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Chernyshov Igor Moscow, Russian Federation More articles by this author Kamil Kallaev Moscow, Russian Federation More articles by this author Denis Altunin Moscow, Russian Federation More articles by this author Alexei Jernov Moscow, Russian Federation More articles by this author Iskander Abdullin Moscow, Russian Federation More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...