Significance and management of positive surgical margins at the time of radical prostatectomy Journal Article
| Authors: | Silberstein, J.; Eastham, J. |
| Article Title: | Significance and management of positive surgical margins at the time of radical prostatectomy |
| Abstract: | Positive surgical margins (PSM) at the time of radical prostatectomy (RP) result in an increased risk of biochemical recurrence (BCR) and secondary treatment. We review current literature with a focus on stratifying the characteristics of the PSM that may define its significance, the impact of modern imaging and surgical approaches in avoidance of PSM, and management strategies when PSM do occur. We performed a review of the available literature to identify factors associated with PSM and their management. PSM have been repeatedly demonstrated to be associated with an increased risk of BCR following RP. The specific characteristics (size, number, location, Gleason score at the margin) of the PSM may influence the risk of recurrence. Novel imaging and surgical approaches are being investigated and may allow for reductions of PSM in the future. The use of adjuvant treatment for a PSM remains controversial and should be decided on an individual basis after a discussion about the risks and benefits. The goal of RP is complete resection of the tumor. PSM are associated with increased risk of BCR and secondary treatments. Of the risk factors associated with BCR after RP, a PSM is directly influenced by surgical technique. |
| Keywords: | cancer survival; overall survival; cancer recurrence; cancer risk; conference paper; cancer adjuvant therapy; cancer patient; cancer radiotherapy; comparative study; nuclear magnetic resonance imaging; progression free survival; surgical approach; risk factor; prostate cancer; gleason score; urine incontinence; prostatectomy; radical prostatectomy; androgen deprivation therapy; surgical anatomy; transrectal ultrasonography; biochemical recurrence; robotic; fluorescence imaging; rectum hemorrhage; bladder neck; surgical patient; positive surgical margin; surgical margin; proctitis; biochemical recurrence free survival; human; male; anatomic landmark |
| Journal Title: | Indian Journal of Urology |
| Volume: | 30 |
| Issue: | 4 |
| ISSN: | 0970-1591 |
| Publisher: | Medknow Publications |
| Date Published: | 2014-10-01 |
| Start Page: | 423 |
| End Page: | 428 |
| Language: | English |
| DOI: | 10.4103/0970-1591.134240 |
| PROVIDER: | scopus |
| PMCID: | PMC4220383 |
| PUBMED: | 25378825 |
| DOI/URL: | |
| Notes: | Export Date: 1 December 2014 -- Source: Scopus |
