[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-436962-105":59,"doc-detail-436962-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","reply-to-nerve-sparing-robotic-assisted-radical-prostatectomy-is-not-associated-with-an-increased-rate-of-positive-surgical-margins","Reply to “Nerve sparing robotic-assisted radical prostatectomy is not associated with an increased rate of positive surgical margins”","","Letter to the editor responding to critiques on a prior Journal of Chinese Medical Association article regarding nerve-sparing robotic-assisted radical prostatectomy and positive surgical margins. The authors clarify interpretation of univariable versus multivariable analyses, emphasize correlations with preoperative PSA level and postoperative pT3 stage, and discuss partial versus complete non-nerve-sparing procedures. They argue that careful patient selection is essential, particularly evaluating PSA and MRI for suspected extraprostatic extension.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/reply-to-nerve-sparing-robotic-assisted-radical-prostatectomy-is-not-associated-with-an-increased-rate-of-positive-surgical-margins/436962/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/reply-to-nerve-sparing-robotic-assisted-radical-prostatectomy-is-not-associated-with-an-increased-rate-of-positive-surgical-margins/436962.png","ImageObject",300,407,{"name":92,"@type":93},"Đào","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the main purpose of this letter?","Question",{"text":112,"@type":113},"To respond to comments and questions on the authors’ reply about nerve-sparing robotic-assisted radical prostatectomy and its association with the positive surgical margin rate.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How do the authors explain differences between univariable and multivariable results?",{"text":117,"@type":113},"They state that although univariable analysis showed differences in positive surgical margins between groups, multivariable analysis did not show a significant difference for overall nerve-sparing versus non-nerve-sparing; instead, PSA level and postoperative pT3 stage were correlated with higher margin rates.",{"name":119,"@type":110,"acceptedAnswer":120},"Why do the authors emphasize evaluating PSA and MRI before partial nerve-sparing?",{"text":121,"@type":113},"They suggest partial nerve-sparing may be linked to a higher positive surgical margin rate due to factors such as a higher proportion of T3 disease with extraprostatic extension, so PSA and MRI evaluation should be carefully interpreted to guide complete versus partial nerve-sparing decisions.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},436962,1790890704,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":81,"preview_page_count":4},1374402968488,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","J Chin MedAssoc  \nLETTER TO THE EDITOR  \nReply to “Nerve sparing robotic-assisted radical prostatectomy is not associated with an increased rate of positive surgical margins”  \nChing-Wei Yanga,b,c,d, Hsiao-Jen Chungc,e,*  \naDepartment of Urology, Cheng-Hsin General Hospital, Taipei, Taiwan, ROC; bInstitute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; cShu-Tien Urological Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; dWellcome EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, United Kingdom; eDepartment of Urology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC  \nDEAR EDITOR,  \nWe 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.  \nCurrent 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 nonNS groups in univariable analysis (29.1% vs. 50%; p = 0.047) . However, the impact of NS on the PSM rate did not show significant difference between all NS and non-NS groups (p = 0.742) in multivariable analysis but preoperative PSA level (p = 0.047) and postoperative pT3 stage (p \u003C 0.001) were correlated with the higher PSM rate.3 The patients who underwent partial NS procedures slightly had a higher PSM rate than non-NS groups in multivariable analysis (p = 0.046; odds ratio = 2.23).2 The key reason should be a high percentage of T3 prostate cancer with extraprostatic extension (EPE) for the patients underwent partial NS procedures. Therefore, PSA level and MRI image evaluation  \nshould be carefully interpreted before performing partial NS procedures especially for prostate cancer with a suspicion of EPE. The cases with low possibility of EPE before surgery would be feasible for complete NS procedures without worsening the PSM rate.4 Correct case selection is required before performing partial NS techniques.2 We hope these explanations will suffice the readers’ and the authors’ expectations. Thank you for your interest again.  \nREFERENCES  \n1. Yang CW, Wang HH, Hassouna MF, Chand M, Huang WJ, Chung HJ. Reply to ‘The impact of nerve sparing robotic-assisted radical prostatectomy on positive surgical margins: uncertainty’. J Chin Med Assoc 2023;86:255 .  \n2. Yang CW, Wang HH, Hassouna MF, Chand M, Huang WJ, Chung HJ. Effects of nerve-sparing procedures on surgical margins after robot-assisted radical prostatectomy. J Chin Med Assoc 2022;85:1131–5 .  \n3. Yang CW, Wang HH, Hassouna MF, Chand M, Huang WJ, Chung HJ. Prediction of a positive surgical margin and biochemical recurrence after robot-assisted radical prostatectomy. Sci Rep 2021;11:14329 .  \n4. Potdevin L, Ercolani M, Jeong J, Kim IY. Functional and oncologic outcomes comparing interfascial and intrafascial nerve sparing in robot-assisted laparoscopic radical prostatectomies. J Endourol 2009;23:1479–84 .  \n* Address correspondence. Dr. Hsiao-Jen Chung, Department of Urology, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, [ROC. E-mail address: hjchung@vghtpe.gov.tw](ROC. E-mail address: hjchung@vghtpe.gov.tw) (H.-J. Chung).  \nConflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.  \nJournal of Chinese Medical Association. (2023) 86: 618.  \nReceived January 26, 2023; accepted February 8, 2023.  \ndoi: 10. 1097/JCMA.0000000000000902.  \nCopyright © 2023,","cbCaiumdSTedBG5K","https://ap.wps.com/l/cbCaiumdSTedBG5K","pdf",283025,"English","# Letter to the Editor\n## Response to author comments and study interpretation\n## Discussion of patient selection and evaluation\n## References","[{\"question\":\"What is the main purpose of this letter?\",\"answer\":\"To respond to comments and questions on the authors’ reply about nerve-sparing robotic-assisted radical prostatectomy and its association with the positive surgical margin rate.\"},{\"question\":\"How do the authors explain differences between univariable and multivariable results?\",\"answer\":\"They state that although univariable analysis showed differences in positive surgical margins between groups, multivariable analysis did not show a significant difference for overall nerve-sparing versus non-nerve-sparing; instead, PSA level and postoperative pT3 stage were correlated with higher margin rates.\"},{\"question\":\"Why do the authors emphasize evaluating PSA and MRI before partial nerve-sparing?\",\"answer\":\"They suggest partial nerve-sparing may be linked to a higher positive surgical margin rate due to factors such as a higher proportion of T3 disease with extraprostatic extension, so PSA and MRI evaluation should be carefully interpreted to guide complete versus partial nerve-sparing decisions.\"}]","Reply to “Nerve sparing robotic-assisted radical prostatectomy is not associated with an increased rate of positive surgical margins” | PDF",1790679607]