Literature DB >> 15351591

Positive proximal (bladder neck) margin at radical prostatectomy confers greater risk of biochemical progression.

Hakan Aydin1, Toyonori Tsuzuki, David Hernandez, Patrick C Walsh, Alan W Partin, Jonathan I Epstein.   

Abstract

OBJECTIVES: To identify the prognostic significance of positive bladder neck margin as the sole positive margin after radical retropubic prostatectomy for treatment of prostate cancer.
METHODS: We retrospectively analyzed the data from patients who underwent radical retropubic prostatectomy at Johns Hopkins Hospital between 1984 and 2001. Of 164 patients with positive margins, 38 had a positive margin only at the bladder neck margin and 126 had a positive margin at one or more locations separate from the bladder neck margin.
RESULTS: Kaplan-Meier analyses showed that patients with a positive bladder neck margin had a greater biochemical progression risk than patients with positive margins at one or more locations other than the bladder neck margin. The 5-year actuarial risk of progression in men with positive and negative bladder neck margins was 69.8% and 33.0%, respectively. A positive bladder neck margin was statistically an independently significant predictor of progression (P = 0.001), along with the prostatectomy Gleason score (P = 0.0001) in the multivariate analysis. The hazard ratio for predicting progression for postoperative Gleason score and bladder neck positivity was 2.1 and 2.5, respectively. Serum prostate-specific antigen values, clinical stage, age, and the percentage of tumor at the bladder neck margin were not predictors of progression in either univariate or multivariate analysis.
CONCLUSIONS: Patients with a positive bladder neck margin as the sole positive margin at radical retropubic prostatectomy have a greater risk of biochemical progression than patients with one or more positive margins at other locations, although not as adverse as the risk reported for those with Stage T4 disease.

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Year:  2004        PMID: 15351591     DOI: 10.1016/j.urology.2004.04.003

Source DB:  PubMed          Journal:  Urology        ISSN: 0090-4295            Impact factor:   2.649


  10 in total

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Authors:  Takatsugu Okegawa; Shota Omura; Mio Samejima; Naoki Ninomiya; Satoru Taguchi; Yu Nakamura; Tsuyoshi Yamaguchi; Mitsuhiro Tambo; Hiroshi Fukuhara
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9.  Impact of positive surgical margins on biochemical relapse after radical retropubic prostatectomy (RRP).

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10.  Bladder neck sparing in radical prostatectomy.

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  10 in total

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