Prognostic significance of location of positive margins in radical prostatectomy specimens Journal Article

Authors: Eastham, J. A.; Kuroiwa, K.; Ohori, M.; Serio, A. M.; Gorbonos, A.; Maru, N.; Vickers, A. J.; Slawin, K. M.; Wheeler, T. M.; Reuter, V. E.; Scardino, P. T.
Article Title: Prognostic significance of location of positive margins in radical prostatectomy specimens
Abstract: Objectives: Cancer at the resection margin is associated with an increased risk of biochemical recurrence after radical prostatectomy (RP) even after adjusting for other known clinical and pathologic risk factors. In this study, we assessed the prognostic significance of sites of positive surgical margins (+SMs) in RP specimens. Methods: We reviewed the data from 2442 patients with clinical Stage T1-T3 prostate cancer treated with RP from 1983 to 2004 who had had tumor maps generated from whole mount sections. The site of +SMs was assigned to six different areas (apex, bladder neck, seminal vesicle, anterior, posterolateral, and posterior). Results: Of the 2442 patients, 201 (8.2%) had a +SM at a single site and 74 (3.0%) had a +SM at multiple sites in the RP specimen. The posterolateral and apex sections were the most commonly involved sites for a +SM. Those with a +SM had a greater risk of biochemical recurrence than those with negative surgical margins (hazard ratio 1.39, 95% confidence interval 1.004 to 1.92; P = 0.047). We found that a +SM at the posterolateral site was significantly associated with an increased risk of biochemical recurrence (hazard ratio 2.80 for +SMs versus negative SMs at the posterolateral region; 95% confidence interval 1.76 to 4.44). Conclusions: The effect on biochemical recurrence was influenced by the site of the +SM, with a posterolateral location having the most significant effect on prognosis. This heterogeneity of margin status has implications for predictive modeling, as well as the recommendation for adjuvant radiotherapy. © 2007 Elsevier Inc. All rights reserved.
Keywords: adult; controlled study; human tissue; middle aged; major clinical study; cancer localization; cancer recurrence; cancer risk; cancer staging; prostate cancer; confidence interval; prostatic neoplasms; tissue section; prostatectomy; disease progression; seminal vesicle; bladder
Journal Title: Urology
Volume: 70
Issue: 5
ISSN: 0090-4295
Publisher: Elsevier Science, Inc.  
Date Published: 2007-11-01
Start Page: 965
End Page: 969
Language: English
DOI: 10.1016/j.urology.2007.08.040
PUBMED: 18068455
PROVIDER: scopus
Notes: --- - "Cited By (since 1996): 53" - "Export Date: 17 November 2011" - "CODEN: URGYA" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Kentaro Kuroiwa
    28 Kuroiwa
  2. Peter T Scardino
    622 Scardino
  3. Makoto Ohori
    50 Ohori
  4. Andrew J Vickers
    569 Vickers
  5. Angel M Cronin
    145 Cronin
  6. James Eastham
    429 Eastham
  7. Victor Reuter
    928 Reuter