Reply to “The impact of nerve sparing robotic-assisted radical prostatectomy on positive surgical margins: Uncertainty”

Nerve-sparing robotic-assisted radical prostatectomy is not associated with an increased rate of positive surgical margins

“…We appreciate Dr. Yang’s very kind and immediate response 1 to our previous comments, 2 which have been published in the February issue of the Journal of the Chinese Medical Association about their original article in the last December issue of the Journal of the Chinese Medical Association entitled “Effects of nerve-sparing procedures on surgical margins after robot-assisted radical prostatectomy”. 3 As shown by the authors’ response, nerve-sparing robot-assisted radical prostatectomy (NS RARP) did not show a negative impact on the increased positive surgical margins (PSMs) rate using the multivariable analysis model; 1 however, we found that the odds ratio (OR) was less than 1 (0.825), suggesting that it is a trend that prostate cancer patients treated with NS RARP may have a lower risk of PSM than those treated with RARP group, although the difference of PSM between NS RARP and RARP groups did not reach a statistical significance (OR 0.825, 95% confidence interval 0.261-2.602). 1 Additionally, the authors may be at higher risk to mis-interpretate their data based on their description.…”

“…3 As shown by the authors' response, nerve-sparing robot-assisted radical prostatectomy (NS RARP) did not show a negative impact on the increased positive surgical margins (PSMs) rate using the multivariable analysis model; 1 however, we found that the odds ratio (OR) was less than 1 (0.825), suggesting that it is a trend that prostate cancer patients treated with NS RARP may have a lower risk of PSM than those treated with RARP group, although the difference of PSM between NS RARP and RARP groups did not reach a statistical significance (OR 0.825, 95% confidence interval 0.261-2.602). 1 Additionally, the authors may be at higher risk to mis-interpretate their data based on their description. The authors claimed that PSM rates were reported "higher" in NS groups than in non-NS groups in univariable analysis (29.1% vs 50%; p = 0.047).…”

“…The authors claimed that PSM rates were reported “ higher ” in NS groups than in non-NS groups in univariable analysis (29.1% vs 50%; p = 0.047). 1 The aforementioned description in term of “higher” may be mis-interpreted. We supposed the term of “lower” may be a “correct” description, and the description is consistent with the finding that OR is lower than 1.…”

Reply to “Nerve sparing robotic-assisted radical prostatectomy is not associated with an increased rate of positive surgical margins”

“…We thank Dr. Yiu-Tai Lia and Wen-Hsun Chang for the valuable comments and questions on our reply to “ The impact of nerve sparing robotic-assisted radical prostatectomy on positive surgical margins: Uncertainty” published in Journal of the Chinese Medical Association ( J Chin Med Assoc 2023;86:255). 1 The author comments are discussed below.…”

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for the valuable comments and questions on our reply to " The impact of nerve sparing robotic-assisted radical prostatectomy on positive surgical margins: Uncertainty" published in Journal of the Chinese Medical Association (J Chin Med Assoc 2023;86:255). 1 The author comments are discussed below.Current study concluded that "partial" nerve-sparing (NS) procedures have a potential risk of increasing the positive surgical margins rate than complete and non-NS procedures do. 2 According to our previous reply, 1 we incorrectly used the term "higher" and should be changed to positive surgical margins (PSM) rate were reported "lower" in NS groups than in non-NS groups in univariable analysis (29.1% vs. 50%; p = 0.047).

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