Positive Surgical Margins Rate of Retzius-Sparing Robot-Assisted Radical Prostatectomy in a Contemporary, Unselected Cohort.

Purpose To report the positive surgical margins (PSM) rate of Retzius-Sparing Robot-assisted Radical Prostatectomy (RS-RARP) in an unselected, real-life cohort of patients treated at a fellowship-training urological department. Materials and methods Demographic, clinical, and pathological data of 529 consecutive patients who underwent RS-RARP between January 2017 and December 2020 were collected prospectively and analyzed retrospectively in a hospital-approved audit in a European Urology Association Robotic Urology Section (ERUS) approved fellowship program. Overall PSM rates were reported for the entire cohort and for pT2 and pT3 patients separately. We defined clinically significant PSM as any length of > 3 mm or multiple PSM regardless of length. Results The median age of the patients was 64 years. More than 97% of the patients had intermediate or high-risk disease. The pathological stages were T2 (66.5%) and T3 (33.5%). Overall PSM was reported in 13.3% of pT2 patients and 28.9% of pT3 patients. Clinically significant PSM was reported in 43 patients (8.1%), and most of them (27 patients) had pT3 disease. Only 2.6% positive margins were reported at the apex and 0.7% on the anterior surface and bladder neck. Immediate continence (defined as no pads or 1 safety pad a day) rate was 65%. Conclusions PSM rates of RS-RARP are acceptable and higher in pT3 disease compared to pT2.