Biochemical recurrence rate in patients with positive surgical margins at radical prostatectomy with further negative resected tissue Journal Article
| Authors: | Rabbani, F.; Vora, K. C.; Yunis, L. H. ; Eastham, J. A.; Guillonneau, B.; Scardino, P. T.; Touijer, K. |
| Article Title: | Biochemical recurrence rate in patients with positive surgical margins at radical prostatectomy with further negative resected tissue |
| Abstract: | Objective To determine the biochemical recurrence (BCR) rate in patients with positive surgical margins (PSMs) on the prostate specimen who have additional negative tissue resected from that site (M+-), compared to patients with negative margins (M-) and those with persistent PSM (M+), as those with PSM at radical prostatectomy (RP) are at greater risk of BCR, and in some instances where suspicious tissue is noted in the prostate bed or when frozen-section analysis shows PSM, additional tissue is resected from the suspect site of the PSM. Patients and Methods Between January 1999 and June 2007, 4217 consecutive patients underwent open or laparoscopic RP with no previous radiotherapy or hormonal therapy. The median (interquartile range) follow-up was 37.4 (21.1-60.7) months. Results Pathological organ-confined (OC) cancer was present in 2901 men, of whom 2659 had M-, 216 had M+, and 26 had M+-. Extracapsular extension (ECE) alone with no seminal vesicle or lymph node involvement was present in 843 men, of whom 657 had M-, 174 had M+ and 12 had M+-. For patients with OC cancer, the 36-month actuarial BCR-free probability was 97.9% (95% confidence interval 97.3-98.5) for M-, vs 89.0 (84.1-93.9)% for M+ vs 100% for M+-. For patients with ECE, the 36-month actuarial BCR-free probability was 83.7 (80.0-87.4)% for M- vs 73.7 (66.1-81.3)% for M+ vs 90.0 (71.4-100)% for M+-. The main limitation of the study was its retrospective nature, with the reason for resection of additional tissue not always well documented. Conclusions While the few patients with PSMs and further negative resected tissue limited the statistical analysis, it would appear that in these patients the disease behaves as in those with negative margins. © 2009 BJU International. |
| Keywords: | controlled study; human tissue; middle aged; major clinical study; comparative study; recurrence risk; follow up; antineoplastic agent; laparoscopic surgery; neoplasm recurrence, local; pathology; retrospective study; prostate cancer; prostate-specific antigen; prostatic neoplasms; prostate; neoplasm, residual; probability; prostatectomy; epidemiologic methods; margin; frozen section; biochemistry; frozen sections |
| Journal Title: | BJU International |
| Volume: | 104 |
| Issue: | 5 |
| ISSN: | 1464-4096 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2009-09-01 |
| Start Page: | 605 |
| End Page: | 610 |
| Language: | English |
| DOI: | 10.1111/j.1464-410X.2009.08757.x |
| PUBMED: | 19689577 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 30 November 2010" - "CODEN: BJINF" - "Source: Scopus" |
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