I read with great interest the article by Kupski discussing the risk of a positive margin in the intraoperative and final pathology depending on the risk group for biochemical recurrence in biopsy specimens after nerve-sparing (NS) robot-assisted radical prostatectomy (RaRP) [1].After reading the article, I propose some considerations for which clarification would be helpful.It seems that NS RaRP was applied to patients in the low, intermediate and high-risk groups of localised prostate cancer, but it was not clearly stated in the study which criteria were used when making the decision to undergo NS surgery. How was the risk of extraprostatic spread evaluated? Was the NS decision made with preoperative magnetic resonance (MR) findings or by using a preoperative nomogram? This is an important factor and should be noted.There are many studies showing that additional surgical excision reduces the positive surgical margin in the final pathology in patients with a positive intraoperative frozen result of the neurovascular bundle [2, 3, 4].There were 18 patients with positive surgical margins in the intraoperative frozen examination in your study, but it was stated that only 8 patients had additional surgical excision.Why was the additional surgical excision not performed in the remaining 10 patients with positive margins?
Authors: Thorsten Schlomm; Pierre Tennstedt; Caroline Huxhold; Thomas Steuber; Georg Salomon; Uwe Michl; Hans Heinzer; Jens Hansen; Lars Budäus; Stefan Steurer; Corinna Wittmer; Sarah Minner; Alexander Haese; Guido Sauter; Markus Graefen; Hartwig Huland Journal: Eur Urol Date: 2012-05-10 Impact factor: 20.096
Authors: Felix Preisser; Lena Theissen; Peter Wild; Katharina Bartelt; Luis Kluth; Jens Köllermann; Markus Graefen; Thomas Steuber; Hartwig Huland; Derya Tilki; Frederik Roos; Andreas Becker; Felix K-H Chun; Philipp Mandel Journal: Eur Urol Focus Date: 2019-03-21