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Prostate cancer: Nerve-sparing surgery is a predictor of positive margins

Key clinical point: In patients with prostate cancer undergoing robot-assisted radical prostatectomy, nerve-sparing surgery is a key predictor of positive margins. Other predictors include high biopsy grade, extraprostatic extension on magnetic resonance imaging (MRI), and a higher percentage of positive cores.

Major finding: Independent predictors (adjusted odds ratios) of a positive surgical margin were nerve-sparing surgery (1.42; P = .005), prostate-specific antigen density (3.64; P less than .001), extraprostatic extension on MRI (1.42; P = .031), percentage of positive cores on systematic biopsy (3.82; P less than .001), and higher biopsy grade: grade 2 (1.58; P = .015), grade 3 (1.62; P = .037), grade 4 (2.11; P = .002), and grade 5 (4.43; P less than .001).

Study details: The study included 2,574 patients with prostate cancer who underwent robot-assisted radical prostatectomy.

Disclosures: The study was supported by Astellas Pharma and Amgen. The authors declared no conflicts of interest.


Soeterik TFW et al. J Urol. 2020 Jul 1. doi: 10.1097/JU.0000000000000760.