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Cumulative summation graphs are a useful tool for monitoring positive surgical margin rates in robot-assisted radical prostatectomy.
After intervention, subjects in the intervention group had smaller tumors (80% vs 45%, less than 4 ml), less involvement of surgical margins and/or extra-prostatic tissues with cancer (73% vs 18%, organ-confined disease), and less diffuse involvement of the prostate by high-grade prostatic intraepithelial neoplasia (33% vs 0%, focal involvement) compared with subjects in the control group.
Early literature recommends surgical margins of 4 to 6 cm, the current recommendations of surgical margins is at least 2 cm, preferably 3cm (8).
1,11-13) Location at the base of the appendix is not proven to confer a less-favorable prognosis, but it may change the therapeutic decision if there is involvement of the surgical margin.
Patient age, preoperative PSA, prostate volume, pathologic stage, Gleason score, surgical margin status, lymph node status, type of nerve-sparing, and type of bladder neck preparation were recorded prospectively in a specific database on Excel.
Category Variable Age <50 50-69 [greater than or equal to]70 Race White All Others Insurance Status Insurance NOS Medicare/Medicaid Self-Pay Unknown Employment Status Employed Unemployed or Unknown Radiation Facility in County Yes of Residence No Tumor Size <1cm [greater than or equal to]1cm Surgical Margins Positive/close Negative Received Hormone and/ or Chemo Therapy Yes No HER2/neu Negative Positive Not Done Unknown ER Status Negative Positive % Who Completed Total Radiation Population Therapy Category N % N % p-value Age 22 21.
Positive surgical margin rates were similar with each operation.
Bastian and his coworkers noted that their study was observational, and that before any serious reevaluation of recommended surgical margins can be undertaken, there will need to be case-control and prospective studies confirming that field cells result in local melanoma recurrence.