OBESITY AND CAPSULAR INCISION AT THE TIME OF OPEN RETROPUBIC RADICAL PROSTATECTOMY
2005; Lippincott Williams & Wilkins; Volume: 174; Issue: 5 Linguagem: Inglês
10.1097/01.ju.0000177077.53037.72
ISSN1527-3792
AutoresStephen J. Freedland, Kelly A. Grubb, Sindy K. Yiu, Matthew E. Nielsen, Leslie A. Mangold, William B. Isaacs, Jonathan I. Epstein, Alan W. Partin,
Tópico(s)Urologic and reproductive health conditions
ResumoNo AccessJournal of UrologyAdult Urology: Oncology: Prostate/Testis/Penis/Urethra1 Nov 2005OBESITY AND CAPSULAR INCISION AT THE TIME OF OPEN RETROPUBIC RADICAL PROSTATECTOMY STEPHEN J. FREEDLAND, KELLY A. GRUBB, SINDY K. YIU, MATTHEW E. NIELSEN, LESLIE A. MANGOLD, WILLIAM B. ISAACS, JONATHAN I. EPSTEIN, and ALAN W. PARTIN STEPHEN J. FREEDLANDSTEPHEN J. FREEDLAND , KELLY A. GRUBBKELLY A. GRUBB , SINDY K. YIUSINDY K. YIU , MATTHEW E. NIELSENMATTHEW E. NIELSEN , LESLIE A. MANGOLDLESLIE A. MANGOLD , WILLIAM B. ISAACSWILLIAM B. ISAACS , JONATHAN I. EPSTEINJONATHAN I. EPSTEIN , and ALAN W. PARTINALAN W. PARTIN View All Author Informationhttps://doi.org/10.1097/01.ju.0000177077.53037.72AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The goal of radical prostatectomy (RP) is complete removal of the intact prostate. Obese men can represent a technical challenge. However, to our knowledge objective data linking obesity with technically inferior surgery are lacking. Therefore, we examined the association between body mass index (BMI) and capsular incision at RP as a surrogate of a poor technical operation in men treated for prostate cancer by several high volume surgeons at a center of excellence. Materials and Methods: The study population consisted of 7,027 men treated with anatomical retropubic RP between 1996 and 2004 by 7 high volume surgeons. We evaluated the association between BMI and capsular incision using logistic regression, adjusting for clinical and pathological variables, and for the surgeon. Results: Overall capsular incision was noted in 4.6% of all RP specimens. After adjustment for preoperative prostate specific antigen, patient race, height, year of surgery, clinical stage, pathological Gleason sum, prostate weight, extraprostatic extension and seminal vesicle invasion increased BMI was associated with increased odds of capsular incision (p trend = 0.005). After further adjustment for surgeon mild obesity was associated with 30% increased odds of capsular incision (OR 1.30, 95% CI 0.92 to 1.83), while moderate and severe obesity was associated with 57% increased odds of capsular incision (OR 1.57, 95% CI 0.82 to 3.00) relative to normal weight men (p trend = 0.06). Conclusions: In a study of more than 7,000 men treated by 7 experienced surgeons BMI was positively related to capsular incision. This suggests that open retropubic RP is technically more difficult in obese men, which results in a greater likelihood of a less than technically ideal operation. 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Google Scholar From The James Buchanan Brady Urological Institute (SJF, KAG, SKY, MEN, LAM, WBI, JIE, AWP) and Department of Pathology (JIE), The Johns Hopkins School of Medicine and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medical Institutions (WBI), Baltimore, Maryland© 2005 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byKaplan S (2018) Re: The Impact of Obesity on the Predictive Accuracy of PSA in Men Undergoing Prostate BiopsyJournal of Urology, VOL. 194, NO. 2, (394-395), Online publication date: 1-Aug-2015.Davies B, Smaldone M, Sadetsky N, Dall'era M and Carroll P (2018) The Impact of Obesity on Overall and Cancer Specific Survival in Men With Prostate CancerJournal of Urology, VOL. 182, NO. 1, (112-117), Online publication date: 1-Jul-2009.Freedland S (2018) Editorial CommentJournal of Urology, VOL. 177, NO. 1, (106-106), Online publication date: 1-Jan-2007.Rodriguez A, Kapoor R and Pow-Sang J (2018) Laparoscopic Extraperitoneal Radical Prostatectomy in Complex Surgical CasesJournal of Urology, VOL. 177, NO. 5, (1765-1770), Online publication date: 1-May-2007. Volume 174Issue 5November 2005Page: 1798-1801 Advertisement Copyright & Permissions© 2005 by American Urological Association, Inc.Keywordsprostatic neoplasmsprostateprostatectomyobesitybody mass indexMetricsAuthor Information STEPHEN J. FREEDLAND More articles by this author KELLY A. GRUBB More articles by this author SINDY K. YIU More articles by this author MATTHEW E. NIELSEN More articles by this author LESLIE A. MANGOLD More articles by this author WILLIAM B. ISAACS More articles by this author JONATHAN I. EPSTEIN More articles by this author ALAN W. PARTIN More articles by this author Expand All Advertisement PDF downloadLoading ...
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