Postoperative Leukocytosis After Robotic-Assisted Radical Prostatectomy Is Not Associated with Perioperative Outcome and Histopathological Findings.

INTRODUCTION: Recently a retrospective study has been published describing a significant correlation of immediate postoperative leukocytosis (IPLC) and a favorable pathological Gleason score (pGS) in patients undergoing robotic-assisted radical prostatectomy (RARP). The aim of the present study was to prospectively validate these results on an external dataset.

MATERIALS AND METHODS: In total, 346 patients undergoing RARP as first-line therapy for localized prostate cancer were included. Clinical and histopathological parameters, criteria of IPLC, and pGS were recorded prospectively. Potential association between IPLC and pGS was evaluated by univariate and multivariate analyses.

RESULTS: IPLC was found in 77.2% (n = 267) of all patients with a median leukocyte blood count (LBC) of 12.5 × 10(9)/L (interquartile range, 10.2-15 × 10(9)/L). Of these, in 255 patients IPLC was found within the range of 10-20 × 10(9)/L, whereas an IPLC of >20 × 10(9)/L was found in only 12 patients. Of the patients, 49.1%, 40.5%, and 10.4% presented with a pGS6, pGS7, and pGS8-10 tumor, respectively. There was neither a univariate nor a multivariate correlation between IPLC and pGS. Furthermore, no significant correlation could be detected between IPLC and other clinical, intraoperative, or histopathological criteria. In 175 (66%) patients with IPLC normal LBC levels were measured on postoperative Day 4.

CONCLUSIONS: IPLC was not associated with more favorable tumor biology (lower pGS, better tumor stage) and not influenced by patient conditions (age, body mass index, American Society of Anesthesiologists score, smoking) or intraoperative parameters (blood loss, operating time, surgeon). In addition, there was no significant correlation with serious complications (Clavien-Dindo Grade 3a/b) within a period of 90 days.