Analysis Of Risk Factors For Positive Margin After Laparoscopic Radical Prostatectomy

Objectives: To study the positive rate of surgical margin after laparoscopic radical prostatectomy and the risk factors affecting the positive surgical margin.Materials and methods: A retrospective analysis was conducted to analyze the patients who received LRP in the first hospital of jilin university from June 2013 to June 2019.According to the postoperative pathological margin,the patients were divided into positive margin and negative margin.The age,prostate volume,serum prostate specific antigen,puncture-positive needle number,percentage of positive cores and biopsy Gleason score,Gleason score in final pathology,Pathological stage,the length of interval time between biosy and laparoscopic radical prostatectomy,The ratio of tumor to prostate volume in postoperative,perineural invasion in biopsy were compared;The above variables were first analyzed by single factor analysis,and P<0.05 was considered statistically significant.Then,the P<0.1 variable in univariate analysis were further analyzed by multivariate logistic regression for independent risk factors of positive margins.SPSS23.0 statistical software was used for data statistical analysis,and P<0.05 was considered statistically significant.Result: Among the 70 patients,there are 37 cases of PSM,33 cases of no PSM,and PSM rate was 52.9%.Univariate analyses: age(P=0.074),preoperative PSA(P=0.191),biopsy Gleason score(P=0.105),Gleason score in final pathology(P=0.105),IT(P=0.208),PNIb(P=0.057)were not correlated with PSM.Prostate volume(P=0.005),puncture-positive needle number(P=0.029),percentage of positive cores(P<0.001)and The ratio of tumor to prostate volume in postoperative(P<0.001),Pathological stage(P<0.001)were statistically significant and suggested that these factors were certainly correlated with PSM after LRP.Multivariate analyses outcome: age(OR=0.847,P=0.008),Pathological stage(OR=3.406,P<0.05)and tumor ratio(OR=3.406,P<0.05)were independent risk factors for PSM after LRP.Conclusion:(1)Age,tumor ratio and Pathological stage were independent risk factors for PSM after LRP.(2)Prostate volume,puncture-positive needle number,percentage of positive cores were certainly correlated with PSM after LRP.Howere,preoperative PSA,biopsy Gleason score,Gleason score in final pathology,IT,PNIb had no significant correlation with postoperative PSM.