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Beitragstitel Does an Intraoperative Frozen Section Lower the Positive Margin Rate? Analysis of 196 Consecutive Radical Prostatectomies.
Beitragscode P081
Autor:innen
  1. Scott Putman Uroviva Präsentierende:r
  2. Ladislav Prikler Uroviva Bülach
Präsentationsform unmoderierte Poster
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  • Prostata
Abstract-Text INTRODUCTION AND OBJECTIVES: Patients with positive surgical margins at radical prostatectomy are at an increased risk of biochemical recurrence. In an effort to reduce positive surgical margins, especially when a nerve-sparing operation is performed, some centers advocate intraoperative frozen section with re-resection of tissue in the case of a positive margin. We sought to determine if patients who undergo prostatectomy with intraoperative frozen section experience a lower positive surgical margin rate.
METHODS: Between November 2013 and March 2019 196 consecutive patients underwent DaVinci radical prostatectomy without prior radiation or hormonal therapy. Chi-squared analysis was used to compare the group undergoing radical prostatectomy without intraoperative frozen section analysis and the intraoperative frozen section group. The final positive margin rate was compared in each group. The intraoperative frozen section group was further stratified into four sub-groups: R0 on frozen section and R0 on final histology, R1 on frozen section and R0 on final histology, R1 on frozen section and final histology and R0 on frozen section with R1 on final histology. The rate of biochemical recurrence was also compared in the groups.
RESULTS: The overall positive margin rate was 27%. The positive margin rate for all stages in both the frozen section group and the non-frozen section group was 27%. T2 cancer was present in 101 patients, eight of which had R1 on final histology. 46 of these patients underwent intraoperative frozen section. In the non-frozen section group, the final positive margin rate was 11% and in the frozen section group the final positive margin rate was 4% (p = 0.2). The overall biochemical recurrence rate was 25%. The biochemical recurrence rate in the T2 group was 8%. In the intraoperative frozen section group, the biochemical recurrence rate was 6% and in the non-frozen section group 9%.
CONCLUSIONS: Although the R1 rate for organ-confined disease is lower when an intraoperative frozen section is performed, the small number of patients limits a detailed statistical analysis. The results tend to show a lower R1 rate in the frozen section group, the biochemical occurrence in both groups appear the same.