1404 LYMPHOCELE FOLLOWING EXTRAPERITONEAL ROBOT-ASSISTED RADICAL PROSTATECTOMY: A PROPENSITY SCORE MATCHING STUDY (2013)

You have accessJournal of UrologyTechnology & Instruments: Robotics: Benign & Malignant Disease (II)1 Apr 20131404 LYMPHOCELE FOLLOWING EXTRAPERITONEAL ROBOT-ASSISTED RADICAL PROSTATECTOMY: A PROPENSITY SCORE MATCHING STUDY Joo Yong Lee, Kyu Hyun Kim, Jae Won Park, Richilda Red Diaz, Kwang Hyun Kim, Ho Song Yu, Hye Young Lee, Kang Su Cho, Won Sik Ham, and Young Deuk Choi Joo Yong LeeJoo Yong Lee Seoul, Korea, Republic of More articles by this author , Kyu Hyun KimKyu Hyun Kim Seoul, Korea, Republic of More articles by this author , Jae Won ParkJae Won Park Seoul, Korea, Republic of More articles by this author , Richilda Red DiazRichilda Red Diaz Seoul, Korea, Republic of More articles by this author , Kwang Hyun KimKwang Hyun Kim Seoul, Korea, Republic of More articles by this author , Ho Song YuHo Song Yu Gwangju, Korea, Republic of More articles by this author , Hye Young LeeHye Young Lee Seoul, Korea, Republic of More articles by this author , Kang Su ChoKang Su Cho Seoul, Korea, Republic of More articles by this author , Won Sik HamWon Sik Ham Seoul, Korea, Republic of More articles by this author , and Young Deuk ChoiYoung Deuk Choi Seoul, Korea, Republic of More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2758AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To investigate the incidence of lymphocele and determine the risk factors for postoperative lymphocele following extraperitoneal robot-assisted radical prostatectomy (RARP) in our patients and compare control group who were extracted using propensity score matching (PSM). METHODS A total of 483 patients underwent extraperitoneal RARP for prostate cancer between January 2009 and August 2011. Of these, 200 patients underwent pelvic lymph node dissection (PLND) during RARP (Figure 1). All patients underwent magnetic resonance imaging or computed tomography postoperatively to detect lymphocele following RARP. PSM for an established control group were calculated for each patient using multivariate logistic regression. RESULTS Lymphocele was identified in 41 patients (20.5%). PSM was performed to select for the most similar propensity scores across group without postoperative lymphocele in a 1:1 ratio with respect to the reference group of patients who underwent RARP with postoperative lymphocele. There were no statistical differences in variables used in propensity score matching. On seminal vesicle invasion (SVI) (P=0.015) and tumor volume (V1; P=0.048, V3; P=0.041) between two groups, there were significant differences. On the multivariate logistic regression model, extracapsular extension (ECE) (P=0.012, OR=4.223), SVI (P=0.022, OR=2.661) and the number of positive lymph nodes (P=0.042, OR=3.565) were an independent risk factor for lymphocele development following extraperitoneal RARP with PNLD (Table 1). CONCLUSIONS In PSM, lymphocele may develop in cases with SVI and large tumor volume. In addition, ECE, SVI and the number of positive lymph nodes are independent risk factors of postoperative lymphocele following extraperitoneal RARP. Table 1. Univariate and multivariate logistic regression models on development of postoperative lymphocele in extraperitoneal RARP Covariate Odds ratio P-value 95% CI Univariate analysis Age 1.001 0.961 0.954-1.051 BMI 0.973 0.665 0.861-1.100 PSA 1.002 0.290 0.999-1.005 Prostate volume 0.979 0.121 0.953-1.006 Preoperative GS 1.395 0.092 0.947-2.056 Operation time 1.005 0.444 0.991-1.020 No. of harvested LN 1.045 0.118 0.989-1.104 EBL 1.000 0.639 0.999-1.001 ECE 5.575 0.002 1.861-16.704 HGPIN 0.595 0.184 0.276-1.281 SVI 3.435 0.002 1.565-7.539 PSM 1.289 0.488 0.628-2.647 Postoperative GS 1.330 0.125 0.924-1.915 pT2 0.816 0.638 0.349-1.904 pT3 1.261 0.566 0.571-2.788 pT4 0.560 0.602 0.063-4.940 pN 6.514 0.011 1.548-27.405 No. of PLN 4.883 0.008 1.504-15.856 V1 0.142 0.010 0.032-0.624 V2 1.169 0.671 0.569-2.402 V3 2.798 0.011 1.261-6.210 Multivariate analysis ECE 4.223 0.012 1.377-12.947 SVI 2.661 0.022 1.150-6.158 No. of PLN 3.565 0.042 1.047-12.140 RARP: robot-assisted radical prostatectomy, CI: confidential interval, BMI: body mass index, PSA: prostate-specific antigen, GS: Gleason sum, LN: lymph nodes, EBL: estimated blood loss, ECE: extracapsular extension, HGPIN: high grade prostatic intraepithelial neoplasia, SVI: seminal vesicle invasion, PSM: positive surgical margin, PLN: postive LN © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e574-e575 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joo Yong Lee Seoul, Korea, Republic of More articles by this author Kyu Hyun Kim Seoul, Korea, Republic of More articles by this author Jae Won Park Seoul, Korea, Republic of More articles by this author Richilda Red Diaz Seoul, Korea, Republic of More articles by this author Kwang Hyun Kim Seoul, Korea, Republic of More articles by this author Ho Song Yu Gwangju, Korea, Republic of More articles by this author Hye Young Lee Seoul, Korea, Republic of More articles by this author Kang Su Cho Seoul, Korea, Republic of More articles by this author Won Sik Ham Seoul, Korea, Republic of More articles by this author Young Deuk Choi Seoul, Korea, Republic of More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...