{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:28:03Z","timestamp":1786739283371,"version":"build-2736575974"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      We investigated the relationship between positive surgical margin (PSM)-related factors and biochemical recurrence (BCR) and the ability of intraoperative frozen sections to predict significant PSM in patients with prostate cancer. The study included 271 patients who underwent robot-assisted laparoscopic prostatectomy with bilateral nerve sparing and maximal urethral preservation. Intraoperative frozen sections of the periurethra, dorsal vein, and bladder neck were analyzed. The ability of PSM-related factors to predict BCR and significant PSM was assessed by logistic regression. Of 271 patients, 108 (39.9%) had PSM and 163 (60.1%) had negative margins. Pathologic Gleason score \u22658 (18.9%\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      7.5%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.015) and T stage \u2265T3a (51.9%\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      24.6%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) were significantly more frequent in the PSM group. Multivariate analysis showed that Gleason pattern \u22654 (\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      &lt;4; hazard ratio: 4.386;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.0004) was the only significant predictor of BCR in the PSM cohort. Periurethral frozen sections had a sensitivity of 83.3% and a specificity of 84.2% in detecting PSM with Gleason pattern \u22654. Multivariate analysis showed that membranous urethra length (odds ratio [OR]: 0.79,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.0376) and extracapsular extension of the apex (OR: 4.58,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.0226) on magnetic resonance imaging (MRI) and positive periurethral tissue (OR: 17.85,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001) were associated with PSM of the apex. PSM with Gleason pattern \u22654 is significantly predictive of BCR. Intraoperative frozen sections of periurethral tissue can independently predict PSM, whereas sections of the bladder neck and dorsal vein could not. Pathologic examination of these samples may help predict significant PSM in patients undergoing robot-assisted laparoscopic prostatectomy with preservation of functional outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aja.aja_16_20","type":"journal-article","created":{"date-parts":[[2020,5,1]],"date-time":"2020-05-01T08:08:49Z","timestamp":1588320529000},"page":"74-79","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Does intraoperative frozen section really predict significant positive surgical margins after robot-assisted laparoscopic prostatectomy? A retrospective study"],"prefix":"10.4103","volume":"23","author":[{"given":"Se Young","family":"Choi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byung Hoon","family":"Chi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae-Hyoung","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bumjin","family":"Lim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wonchul","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalsan","family":"You","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Choung-Soo","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-14-20240829","doi-asserted-by":"crossref","first-page":"2106","DOI":"10.1016\/j.juro.2007.03.003","article-title":"Guideline for the management of clinically localized prostate cancer: 2007 update","volume":"177","author":"Thompson","year":"2007","journal-title":"J Urol"},{"key":"R2-14-20240829","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1186\/s12957-018-1433-3","article-title":"Positive surgical margin is associated with biochemical recurrence risk following radical prostatectomy: a meta-analysis from high-quality retrospective cohort studies","volume":"16","author":"Zhang","year":"2018","journal-title":"World J Surg Oncol"},{"key":"R3-14-20240829","doi-asserted-by":"crossref","first-page":"303","DOI":"10.5858\/2006-130-303-KIIHAR","article-title":"Key issues in handling and reporting radical prostatectomy specimens","volume":"130","author":"Srigley","year":"2006","journal-title":"Arch Pathol Lab Med"},{"key":"R4-14-20240829","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.purol.2013.11.006","article-title":"Prostate cancer surgical margin: review by the CCAFU (oncology committee of the French association of urology)","volume":"24","author":"Cormier","year":"2014","journal-title":"Prog Urol"},{"key":"R5-14-20240829","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.urolonc.2009.07.014","article-title":"Radical prostatectomy: does surgical technique influence margin control?","volume":"28","author":"Gettman","year":"2010","journal-title":"Urol Oncol"},{"key":"R6-14-20240829","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1111\/iju.13247","article-title":"Clinical benefits of frozen section assessment during urological surgery: does it contribute to improving surgical margin status and patient outcomes as previously thought?","volume":"24","author":"Miyamoto","year":"2017","journal-title":"Int J Urol"},{"key":"R7-14-20240829","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1111\/bju.14480","article-title":"The impact on oncological outcomes after radical prostatectomy for prostate cancer of converting soft tissue margins at the apex and bladder neck from tumour-positive to -negative","volume":"123","author":"Pak","year":"2019","journal-title":"BJU Int"},{"key":"R8-14-20240829","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.eururo.2013.12.014","article-title":"A feasible and time-efficient adaptation of NeuroSAFE for da Vinci robot-assisted radical prostatectomy","volume":"66","author":"Beyer","year":"2014","journal-title":"Eur Urol"},{"key":"R9-14-20240829","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.eururo.2012.04.057","article-title":"Neurovascular structure-adjacent frozen-section examination (NeuroSAFE) increases nerve-sparing frequency and reduces positive surgical margins in open and robot-assisted laparoscopic radical prostatectomy: experience after 11,069 consecutive patients","volume":"62","author":"Schlomm","year":"2012","journal-title":"Eur Urol"},{"key":"R10-14-20240829","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1016\/j.juro.2009.06.046","article-title":"Location, extent and number of positive surgical margins do not improve accuracy of predicting prostate cancer recurrence after radical prostatectomy","volume":"182","author":"Stephenson","year":"2009","journal-title":"J Urol"},{"key":"R11-14-20240829","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/j.juro.2015.08.002","article-title":"Importance of reporting the Gleason score at the positive surgical margin site: analysis of 4,082 consecutive radical prostatectomy cases","volume":"195","author":"Kates","year":"2016","journal-title":"J Urol"},{"key":"R12-14-20240829","doi-asserted-by":"crossref","first-page":"1794","DOI":"10.1111\/j.1464-410X.2011.10572.x","article-title":"High Gleason grade carcinoma at a positive surgical margin predicts biochemical failure after radical prostatectomy and may guide adjuvant radiotherapy","volume":"109","author":"Savdie","year":"2012","journal-title":"BJU Int"},{"key":"R13-14-20240829","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S0022-5347(05)00152-7","article-title":"Long-term prognostic significance of primary Gleason pattern in patients with Gleason score 7 prostate cancer: impact on prostate cancer specific survival","volume":"175","author":"Tollefson","year":"2006","journal-title":"J Urol"},{"key":"R14-14-20240829","doi-asserted-by":"crossref","first-page":"2385","DOI":"10.1016\/j.juro.2007.08.008","article-title":"A comparison of the incidence and location of positive surgical margins in robotic assisted laparoscopic radical prostatectomy and open retropubic radical prostatectomy","volume":"178","author":"Smith","year":"2007","journal-title":"J Urol"},{"key":"R15-14-20240829","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.urology.2007.03.050","article-title":"Impact of urethral stump length on continence and positive surgical margins in robot-assisted laparoscopic prostatectomy","volume":"70","author":"Borin","year":"2007","journal-title":"Urology"},{"key":"R16-14-20240829","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1097\/00000478-198901000-00003","article-title":"The prostatic capsule: does it exist.Its importance in the staging and treatment of prostatic carcinoma?","volume":"13","author":"Ayala","year":"1989","journal-title":"Am J Surg Pathol"},{"key":"R17-14-20240829","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1016\/S0022-5347(01)63757-1","article-title":"Male pelvic anatomy reconstructed from the visible human data set","volume":"159","author":"Brooks","year":"1998","journal-title":"J Urol"},{"key":"R18-14-20240829","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1007\/s00345-008-0360-2","article-title":"Value of frozen section biopsies during radical prostatectomy: significance of the histological results","volume":"27","author":"Ramirez-Backhaus","year":"2009","journal-title":"World J Urol"},{"key":"R19-14-20240829","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.urology.2011.03.022","article-title":"Intraoperative frozen section analysis of urethral margin biopsies during radical prostatectomy","volume":"78","author":"Ye","year":"2011","journal-title":"Urology"},{"key":"R20-14-20240829","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/j.urology.2003.10.017","article-title":"Role of intraoperative biopsies during radical retropubic prostatectomy","volume":"63","author":"Lepor","year":"2004","journal-title":"Urology"},{"key":"R21-14-20240829","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1111\/bju.13987","article-title":"Multiparametric magnetic resonance imaging identifies significant apical prostate cancers","volume":"121","author":"Kenigsberg","year":"2018","journal-title":"BJU Int"},{"key":"R22-14-20240829","doi-asserted-by":"crossref","first-page":"e4519","DOI":"10.1097\/MD.0000000000004519","article-title":"Multiparametric magnetic resonance imaging and frozen-section analysis efficiently predict upgrading, upstaging, and extraprostatic extension in patients undergoing nerve-sparing robotic-assisted radical prostatectomy","volume":"95","author":"Bianchi","year":"2016","journal-title":"Medicine (Baltimore"},{"key":"R23-14-20240829","doi-asserted-by":"crossref","first-page":"e028132","DOI":"10.1136\/bmjopen-2018-028132","article-title":"NeuroSAFE robot-assisted laparoscopic prostatectomy versus standard robot-assisted laparoscopic prostatectomy for men with localised prostate cancer (NeuroSAFE PROOF): protocol for a randomised controlled feasibility study","volume":"9","author":"Dinneen","year":"2019","journal-title":"BMJ Open"}],"container-title":["Asian Journal of Andrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aja.aja_16_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T19:27:34Z","timestamp":1786735654000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aja.aja_16_20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/aja.aja_16_20","relation":{},"ISSN":["1008-682X"],"issn-type":[{"value":"1008-682X","type":"print"}],"subject":[],"published":{"date-parts":[[2021,1]]}}}