手术切缘阳性（PSM）不仅是复发、转移和预后的独立危险因素，也是前列腺癌（PCa）根治性切除术（RP）患者辅助治疗的重要指标。目前，分析腹腔镜 RP（LRP）中 PSM 危险因素的报道较少，尤其是接受新辅助激素治疗（NHT）的 PCa 病例。因此，本研究的目的是探讨伴或不伴NHT的PCa患者LRP后出现PSM的危险因素。对2012年1月至2020年7月接受LRP的患者的临床病理资料进行回顾性分析。分别探讨 NHT 组和非 NHT 组 LRP 后 PSM 的危险因素。总体 PSM 率为 33.3%（90/270），无 NHT 组 PSM 率为 39.3%（64/163），无 NHT 组 PSM 率为 24.3%（26/26）。 107) 患有 NHT 的人。非NHT组中PSM最常见的部位是心尖部（68.8%，44/64），NHT组中PSM最常见的部位是眼底（57.7%，15/26）。多元logistic回归显示，体重指数（BMI）、PSA、LRP后ISUP分级、病理分期T（pT）和病理淋巴结状态（pN）是影响无NHT患者PSM的独立因素（OR=1.160，95%） CI：1.034-1.301，p=0.011；OR=3.385，95%CI：1.386-8.268，p=0.007；OR=3.541，95%CI：1.008-12.444，p=0.049；OR=4.577，95%CI： 2.163-9.686，p<0.001；OR=3.572，95%CI：1.124-11.347，p=0.031），而pT、pN和淋巴血管侵犯（LVI）是影响NHT患者PSM的独立危险因素（OR=18.434） , 95%CI:4.976-68.297, p<0.001;OR=7.181, 95%CI:2.089-24.689, p=0.002;OR=3.545, 95%CI:1.109-11.327, p=0.033)。 NHT组最常见，LRP后BMI、PSA、ISUP、pT、pN是影响NHT患者PSM的独立危险因素；非NHT组中最常见的部位是眼底，pT、pN、LVI是影响非NHT患者PSM的独立危险因素。版权所有©2023 Wang、Zhang、Tang、Wang、Li、Xing。

Positive surgical margins (PSM) is not only an independent risk factor for recurrence, metastasis, and prognosis, but also an important indicator of adjuvant therapy for prostate cancer (PCa) patients treated with radical prostatectomy (RP). At present, there are few reports analyzing risk factors of PSM in laparoscopic RP (LRP), especially for those PCa cases who accepted neoadjuvant hormonal therapy (NHT). Hence, the aim of the current study was to explore risk factors for PSM after LRP in PCa patients with and without NHT.The clinicopathological data of patients who underwent LRP from January 2012 to July 2020 was retrospectively analyzed. Risk factors for PSM after LRP in NHT and non-NHT groups were respectively explored.The overall PSM rate was 33.3% (90/270), PSM rate was 39.3% (64/163) in patients without NHT and 24.3% (26/107) in those with NHT. The apex was the most common location of PSM in non-NHT group (68.8%, 44/64), while the fundus was the most common location of PSM in NHT group (57.7%, 15/26). Multiple logistic regression revealed that body mass index (BMI), PSA, ISUP grade after LRP, pathological stage T (pT) and pathological lymph node status (pN) were independent factors affecting the PSM for patients without NHT (OR=1.160, 95%CI:1.034-1.301, p=0.011; OR=3.385, 95%CI:1.386-8.268, p=0.007; OR=3.541, 95%CI:1.008-12.444, p=0.049; OR=4.577, 95%CI:2.163-9.686, p<0.001; OR=3.572, 95%CI:1.124-11.347, p=0.031), while pT, pN, and lymphovascular invasion (LVI) were independent risk factors affecting PSM for patients with NHT (OR=18.434, 95%CI:4.976-68.297, p<0.001; OR=7.181, 95%CI:2.089-24.689, p=0.002; OR=3.545, 95%CI:1.109-11.327, p=0.033).The apex was the most common location in NHT group, and BMI, PSA, ISUP after LRP, pT and pN were independent risk factors affecting PSM for NHT patients; while the fundus was the most common location in non-NHT group, and pT, pN, and LVI were independent risk factors affecting PSM for non-NHT patients.Copyright © 2023 Wang, Zhang, Tang, Wang, Li and Xing.