You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy IV (PD57)1 Sep 2021PD57-06 THE POSITIVE SURGICAL MARGIN RATE IS HIGHER IN RETZIUS-SPARING ROBOTIC PROSTATECTOMY IN ANTERIOR PROSTATE TUMORS BUT NOT IN POSTERIOR TUMORS COMPARED TO CONVENTIONAL ANTERIOR APPROACH Satoshi Washino, Kimitoshi Saito, Yuki Nakamura, Tsuzumi Konishi, and Tomoaki Miyagawa Satoshi WashinoSatoshi Washino More articles by this author , Kimitoshi SaitoKimitoshi Saito More articles by this author , Yuki NakamuraYuki Nakamura More articles by this author , Tsuzumi KonishiTsuzumi Konishi More articles by this author , and Tomoaki MiyagawaTomoaki Miyagawa More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002091.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Though Retzius sparing (RS)-robotic prostatectomy (RS-RP) has an advantage of continence recovery over conventional anterior approach (A-RP), it may be associated with a higher positive surgical margin (PSM) rate compared to A-RP. We studied whether the PSM rate was higher in RS-RP than A-RP and how the tumor location is associated with PSMs. METHODS: We retrospectively reviewed the medical records in patients undergoing RS-RP or A-RP for very low to high-risk prostate cancer according to NCCN risk in our institute from Aug 2017 to Jun 2020. The PSM rate between RS-RP and A-RP was compared. Additionally, patients were divided into three groups according to tumor location in prostatectomy specimen: "Anterior", "Posterior", and "Anterior + Posterior" tumors and the PSM rate between RS-RP and A-RP was compared in each tumor location. RESULTS: A total of 81 and 213 patients underwent RS-RP and A-RP. Median age, PSA levels, or NCCN risk was not significantly different between the two groups. The PSM rate was higher in RS-RP than A-RP in total (33% vs 23%, p=0.072). Especially, the PSM rate was higher in RS-RP than A-RP in "Anterior" and "Anterior+Posterior" tumor (57 and 44% in RS-RP vs 22 and 26% in A-RP, p=0.019 and p=0.078, respectively) whereas it was the same in the two procedures in "Posterior" tumors (14% vs 14%). When the tumor was identified in the anterior lesion in MRI, the PSM rate was two-fold higher in RS-RP than A-RP (53 vs 27%, p=0.045) while there was no significant difference between the two procedures in posterior tumors (27 vs 18%, p=0.23). CONCLUSIONS: RS-RP is associated with a higher PSM rate compared to A-RP in anterior tumors, but not in posterior tumors. Prostate MRI is useful to identify the tumor location, which facilitates predicting the PSM. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1011-e1012 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Satoshi Washino More articles by this author Kimitoshi Saito More articles by this author Yuki Nakamura More articles by this author Tsuzumi Konishi More articles by this author Tomoaki Miyagawa More articles by this author Expand All Advertisement Loading ...