ESTRO 2024 - Abstract Book

S2586

Clinical - Urology

ESTRO 2024

radiological and pathological staging in patients undergoing radical robot assisted laparoscopic prostatectomy (RALP).

Material/Methods:

We screened patients undergoing radical robot assisted RALP as management of histologically proven prostate carcinoma between 1st January 2021 till 31st December 2022 at the Royal Marsden Hospital, UK. We compared TNM staging determined from preoperative mpMRI of Pelvis and centrally reviewed prostatectomy specimen.

Results:

385 patients were screened, and 375 patients were eligible. Median age was 63 years, (60-68 IQR), median PSA was 6.0ng/dL (4.1-8.9 IQR), median Gleason score (GS) in biopsy specimen was 3+4. Radiological staging was T1 in2.1%(n=8), T2 in74.9% (n=281), T3a in17.6% (n=66, T3b-4.3%(n=16), T3a+T3b in 0.8%(n=3) and T4 in0.3% (n=1). All patients were node negative radiologically. Post operative staging was pT2 in 43.2%(n=162), pT3a in45.6% (n=171), pT3b in0.8%(n=3) and pT3a+3b in10.4% (n=39). Bilateral seminal vesicles were involved in 6 patients. Lymphadenectomy was performed in 18.6%(n=70) patients and 9/70 patients had node positive disease on pathology. GS range in prostatectomy histopathology was like that of biopsy. One hundred patients (26.6%) patients had positive surgical margins; 23 patients had more than one positive margin. There was 60% (n=225) concordance between radiological and pathological staging, 38.1% (n=143) patients were pathologically upstaged and 1.6%(n=6) down staged. Out of 143 patients upstaged, 79% (n=113) initially staged T1/T2 and upstaged pathologically to pT3a, 6.9% (n= 26) were upstaged to involve seminal vesicles.