OBJECTIVES: To define the role of positive surgical margins (PSMs) after radical retropubic prostatectomy as a predictor of biochemical failure (BCF) in prostate cancer with respect to pathologic stage. METHODS: A retrospective cohort study of 300 patients who had undergone radical retropubic prostatectomy from 1993 to 1995 was performed. The role of margin status and the length of the PSM in the progression to BCF was defined after controlling for the preoperative prostate-specific antigen level, Gleason score, tumor stage, tumor volume, seminal vesical invasion, lymphovascular invasion, and perineural invasion using a multivariate regression model. The median follow-up time was 12 years. RESULTS: The presence of PSMs correlated with a shorter time to BCF in men with Stage pT2 disease (P<.0001) but not in men with Stage pT3 disease (P=.66). Of the patients with Stage pT2 disease and PSMs, the PSM length did not correlate with progression to BCF. PSMs predicted a shorter time to progression to BCF in patients with high- and low-volume pT2 disease (P=.0261 and P=.0003, respectively). Only PSMs predicted a shorter time to BCF on multivariate analysis in patients with Stage pT2 cancer (hazard ratio 2.33, 95% confidence interval 1.495-3.723). In patients with Stage pT3 disease, PSMs were not associated with an increased risk of BCF (hazard ratio 0.747, 95% confidence interval 0.328-1.703). CONCLUSIONS: Surgical margin status did not affect the risk of BCF in patients with Stage pT3a disease; however, it did affect patients with Stage pT2 disease, irrespective of PSM length or disease volume. During 12 years of follow-up, the patients with PSMs and Stage pT2 disease had a risk of BCF similar to that of the patients with Stage pT3 disease.
OBJECTIVES: To define the role of positive surgical margins (PSMs) after radical retropubic prostatectomy as a predictor of biochemical failure (BCF) in prostate cancer with respect to pathologic stage. METHODS: A retrospective cohort study of 300 patients who had undergone radical retropubic prostatectomy from 1993 to 1995 was performed. The role of margin status and the length of the PSM in the progression to BCF was defined after controlling for the preoperative prostate-specific antigen level, Gleason score, tumor stage, tumor volume, seminal vesical invasion, lymphovascular invasion, and perineural invasion using a multivariate regression model. The median follow-up time was 12 years. RESULTS: The presence of PSMs correlated with a shorter time to BCF in men with Stage pT2 disease (P<.0001) but not in men with Stage pT3 disease (P=.66). Of the patients with Stage pT2 disease and PSMs, the PSM length did not correlate with progression to BCF. PSMs predicted a shorter time to progression to BCF in patients with high- and low-volume pT2 disease (P=.0261 and P=.0003, respectively). Only PSMs predicted a shorter time to BCF on multivariate analysis in patients with Stage pT2 cancer (hazard ratio 2.33, 95% confidence interval 1.495-3.723). In patients with Stage pT3 disease, PSMs were not associated with an increased risk of BCF (hazard ratio 0.747, 95% confidence interval 0.328-1.703). CONCLUSIONS: Surgical margin status did not affect the risk of BCF in patients with Stage pT3a disease; however, it did affect patients with Stage pT2 disease, irrespective of PSM length or disease volume. During 12 years of follow-up, the patients with PSMs and Stage pT2 disease had a risk of BCF similar to that of the patients with Stage pT3 disease.
Authors: Etienne Xavier Keller; Jacqueline Bachofner; Anna Jelena Britschgi; Karim Saba; Ashkan Mortezavi; Basil Kaufmann; Christian D Fankhauser; Peter Wild; Tullio Sulser; Thomas Hermanns; Daniel Eberli; Cédric Poyet Journal: World J Urol Date: 2018-12-05 Impact factor: 4.226
Authors: Piotr Zareba; Richard Flavin; Masis Isikbay; Jennifer R Rider; Travis A Gerke; Stephen Finn; Andreas Pettersson; Francesca Giunchi; Robert H Unger; Alex M Tinianow; Swen-Olof Andersson; Ove Andrén; Katja Fall; Michelangelo Fiorentino; Lorelei A Mucci Journal: Cancer Epidemiol Biomarkers Prev Date: 2017-01-06 Impact factor: 4.254
Authors: Chin-Lee Wu; Brock E Schroeder; Xiao-Jun Ma; Christopher J Cutie; Shulin Wu; Ranelle Salunga; Yi Zhang; Michael W Kattan; Catherine A Schnabel; Mark G Erlander; W Scott McDougal Journal: Proc Natl Acad Sci U S A Date: 2013-03-26 Impact factor: 11.205
Authors: Yong Jin Kang; Mark Joseph Abalajon; Won Sik Jang; Jong Kyou Kwon; Cheol Yong Yoon; Joo Yong Lee; Kang Su Cho; Won Sik Ham; Young Deuk Choi Journal: PLoS One Date: 2016-07-08 Impact factor: 3.240