旨在调查接受机器人辅助根治性前列腺切除术 (RARP) 并进行术中神经血管结构邻近冰冻切片分析 (NeuroSAFE) 的前列腺癌患者的手术切缘状态，并评估与未接受 NeuroSAFE 的根治性前列腺切除术患者相比的差异。2018 年 9 月期间2021 年 1 月，962 名患者接受了 NeuroSAFE 的集中 RARP 治疗。如果术中冰冻切片 (IFS) 分析显示阳性手术切缘 (PSM)，则进行二次切除，将 PSM 转换为阴性手术切缘 (NSM)。回顾性队列由 2000 年 1 月至 2017 年 12 月期间在没有 NeuroSAFE 的三级中心接受根治性前列腺切除术的 835 名患者组成。在控制临床病理变量后，我们进行了多变量逻辑回归来评估队列之间 PSM 风险的差异。中心诊所在明确的病理 RP 检查中的 PSM 为 29%。最终 PSM 的中位累积长度为 1.1mm（四分位距：0.4-3.8）。在 275 名 PSM 男性中，136 名（49%）的累积长度≤1mm，198 名（72%）≤3mm。在控制 PSA、分级组、筛状模式、pT 分期和 pN 分期后，在集中诊所接受 NeuroSAFE 治疗的患者的 PSM 比值显着降低（比值比 [OR]：0.70，95% 置信区间 [CI] ：0.56-0.88；P = 0.002），PSM 长度 >1 mm（OR：0.14，95% CI：0.09-0.22；P < 0.001），且 >3 mm（OR：0.21，95% CI：0.14-0.30； P < 0.001）。本研究提供了集中 RP NeuroSAFE 队列中手术切缘状态的详细概述。 NeuroSAFE 集中化与较低的 PSM 率和显着较短的 PSM 累积长度相关，表明手术切缘状态的控制得到改善。© 2024 作者。组织病理学由约翰·威利出版

To investigate the surgical margin status in patients with prostate cancer who underwent robot-assisted radical prostatectomy (RARP) with intraoperative neurovascular structure-adjacent frozen-section analysis (NeuroSAFE) and evaluate differences compared to patients who underwent radical prostatectomy without NeuroSAFE.Between September 2018 and January 2021, 962 patients underwent centralized RARP with NeuroSAFE. A secondary resection was performed in case of a positive surgical margin (PSM) on intraoperative frozen section (IFS) analysis to convert a PSM into a negative surgical margin (NSM). A retrospective cohort consisted of 835 patients who had undergone radical prostatectomy in a tertiary centre without NeuroSAFE between January 2000 and December 2017. We performed multivariable logistic regression to evaluate differences in risk of PSM between cohorts after controlling for clinicopathological variables.Patients operated with NeuroSAFE in the centralized clinic had 29% PSM at a definitive pathological RP examination. The median cumulative length of definitive PSM was 1.1 mm (interquartile range: 0.4-3.8). Among 275 men with PSM, 136 (49%) had a cumulative length ≤1 mm and 198 (72%) ≤3 mm. After controlling for PSA, Grade group, cribriform pattern, pT-stage, and pN-stage, patients treated in the centralized clinic with NeuroSAFE had significantly lower odds on PSM (odds ratio [OR]: 0.70, 95% confidence interval [CI]: 0.56-0.88; P = 0.002), PSM length >1 mm (OR: 0.14, 95% CI: 0.09-0.22; P < 0.001), and >3 mm (OR: 0.21, 95% CI: 0.14-0.30; P < 0.001).This study provides a detailed overview of surgical margin status in a centralized RP NeuroSAFE cohort. Centralization with NeuroSAFE was associated with lower PSM rates and significantly shorter PSM cumulative lengths, indicating improved control of surgical margin status.© 2024 The Author(s). Histopathology published by John Wiley & Sons Ltd.