Radical prostatectomy: Positive surgical margins matter Journal Article
| Authors: | Meeks, J. J.; Eastham, J. A. |
| Article Title: | Radical prostatectomy: Positive surgical margins matter |
| Abstract: | Objective: A positive surgical margin (PSM) in the radical prostatectomy (RP) specimen is associated with biochemical recurrence (BCR) and the need for adjuvant radiation therapy, and is a surrogate for surgical quality. We review the available data describing the identification, anatomy, and management of PSM after RP. Methods: A PubMed search (using English language as a filter) was performed to identify factors affecting PSMs and their management. Results: PSMs are associated with an increased likelihood of BCR after RP. The most common location for a PSM is the apex, followed by the posterolateral edge of the prostate. The risk of recurrence in a patient with a PSM is associated with the location, length, and Gleason score of the PSM. The management of a patient with a PSM remains controversial, with some recommending adjuvant radiation therapy for all PSMs and others suggesting only salvage radiation therapy for men who experience BCR. Conclusions: PSMs are associated with an increased likelihood of BCR and often result in initiation of adjuvant treatment. Therefore, the goal of surgery should be to minimize the likelihood of a PSM. © 2013 Elsevier Inc. |
| Keywords: | cancer survival; overall survival; review; cancer recurrence; salvage therapy; cancer adjuvant therapy; cancer radiotherapy; lymph node metastasis; prostate specific antigen; incidence; prostate cancer; gleason score; patient care; urine incontinence; prostatectomy; radical prostatectomy; medline; anatomy; seminal vesicle; biochemical recurrence; predictive value; bladder neck; positive surgical margins; positive surgical margin; urethra stricture; medical parameters; metastasis free survival |
| Journal Title: | Urologic Oncology: Seminars and Original Investigations |
| Volume: | 31 |
| Issue: | 7 |
| ISSN: | 1078-1439 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2013-10-01 |
| Start Page: | 974 |
| End Page: | 979 |
| Language: | English |
| DOI: | 10.1016/j.urolonc.2011.12.011 |
| PROVIDER: | scopus |
| PUBMED: | 22244265 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 November 2013" - "CODEN: UOSOA" - "Source: Scopus" |
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