In a study just published by the British Journal of Urology International, the association between nerve-sparing radical prostatectomy and the risk of increased margins - that is, edges of the removed tumour that show cancer cells – is assessed. Looking at a large cohort of patients who underwent nerve-sparing radical prostatectomy, Dr Moore - a Masters student of Dr Stricker - undertook the study in association with the St Vincent's Prostate Cancer Centre and the Garvan Institute of Medical Research.
St Vincent's Prostate Cancer Centre, as Chaired by Dr Phillip Stricker, is one of five international sites to engage in a study to assess the pentafecta. The pentafecta is a new concept used to report outcomes of minimally invasive robotic surgery and was championed by Vip Patel.
Traditionally surgeons viewed robotic surgery outcomes in terms of the trifecta – cure, continence and potency. However, the pentafecta encompasses two post surgery outcomes – lack of complications and negative surgical margins; that is the absence of cancer in the edges of the removed tumour.
Safe and accurate biopsies are essential to the management of prostate cancer. Whilst the transrectal biopsy is more common in Australia, transperineal biopsy potentially has a lower risk of infection rate and better detection of anterior-based tumours. As a leader in the care of men with prostate cancer and a world initiator of the transperineal technique, Dr Stricker has analysed safety outcomes and detection rates in the transperineal technique with comparison against a USANZ audit of the transrectal technique and a large international series. The findings indicate that the transperineal biopsy is safer and more accurate.
Reporter Natasha Johnson's story, 'Prostate surgery under the microscope', looks at the use of robotic surgery in prostate cancer and the research that compares it to traditional open surgery. Leading prostate specialists give their views.
