PURPOSE: We evaluated the prognostic implication of a positive surgical margin at the prostatic apex to define the risk of failure after radical prostatectomy. MATERIALS AND METHODS: Radical prostatectomy specimens of 590 patients operated on between 1990 and 1994 were reviewed by 2 uropathologists (D. G. and W. S.) to determine the percentage of patients with a positive margin at the apex in the absence of positive margins, extraprostatic extension or involvement of seminal vesicles and pelvic lymph nodes. In this group of 33 patients, the significance of a positive apex could be determined without the influence of any other stage related prognostic factors. Treatment failure was defined as prostate specific antigen greater than 0.4. All 33 patients have been followed between 3.5 and 65.5 months (median 38.7). RESULTS: Among 590 patients 236 (40%) had disease completely confined to the prostate. A total of 217 patients (37%) had either positive surgical margins (M+) or extraprostatic extension and of these, only 33 (5.5%) had an apical positive margin in an otherwise prostate confined tumor. Of 33 apical positive margin patients only 3 in whom surgery failed had progressively detectable prostate specific antigen 3.5 to 65.5 months after surgery. CONCLUSIONS: A positive surgical margin at the prostatic apex in the absence of positive margins or extraprostatic extension elsewhere does not confer a worse prognosis than organ confined disease. In this study the recurrence rate for patients with positive apical margins was the same as for those with confined disease.
PURPOSE: We evaluated the prognostic implication of a positive surgical margin at the prostatic apex to define the risk of failure after radical prostatectomy. MATERIALS AND METHODS: Radical prostatectomy specimens of 590 patients operated on between 1990 and 1994 were reviewed by 2 uropathologists (D. G. and W. S.) to determine the percentage of patients with a positive margin at the apex in the absence of positive margins, extraprostatic extension or involvement of seminal vesicles and pelvic lymph nodes. In this group of 33 patients, the significance of a positive apex could be determined without the influence of any other stage related prognostic factors. Treatment failure was defined as prostate specific antigen greater than 0.4. All 33 patients have been followed between 3.5 and 65.5 months (median 38.7). RESULTS: Among 590 patients 236 (40%) had disease completely confined to the prostate. A total of 217 patients (37%) had either positive surgical margins (M+) or extraprostatic extension and of these, only 33 (5.5%) had an apical positive margin in an otherwise prostate confined tumor. Of 33 apical positive margin patients only 3 in whom surgery failed had progressively detectable prostate specific antigen 3.5 to 65.5 months after surgery. CONCLUSIONS: A positive surgical margin at the prostatic apex in the absence of positive margins or extraprostatic extension elsewhere does not confer a worse prognosis than organ confined disease. In this study the recurrence rate for patients with positive apical margins was the same as for those with confined disease.
Authors: H Wadhwa; M K Terris; W J Aronson; C J Kane; C L Amling; M R Cooperberg; S J Freedland; M R Abern Journal: Prostate Cancer Prostatic Dis Date: 2016-10-04 Impact factor: 5.554
Authors: Sultan Saud Alkhateeb; Shabbir M Alibhai; Antonio Finelli; Neil E Fleshner; Michael A Jewett; Alexandre R Zlotta; John Trachtenberg Journal: Urol Ann Date: 2010-05
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
Authors: Pedro Bargão Santos; Bruno Graça; Miguel Lourenço; Manuel Ferreira Coelho; Fernando Ribeiro; Júlio Fonseca; A Pepe Cardoso; João Varregoso; Fernando Ferrito; Francisco Carrasquinho Gomes Journal: Cent European J Urol Date: 2011-12-09