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Length of Positive Surgical Margin After Radical Prostatectomy as a Predictor of Biochemical Recurrence

2009; Lippincott Williams & Wilkins; Volume: 182; Issue: 1 Linguagem: Inglês

10.1016/j.juro.2009.02.139

1527-3792

Sergey Shikanov, Jie‐Young Song, Cassandra Royce, Hikmat Al‐Ahmadie, Kevin C. Zorn, Gary D. Steinberg, Gregory P. Zagaja, Arieh L. Shalhav, Scott E. Eggener,

Prostate Cancer Treatment and Research

No AccessJournal of UrologyAdult Urology1 Jul 2009Length of Positive Surgical Margin After Radical Prostatectomy as a Predictor of Biochemical Recurrenceis accompanied byPhase II Trial of Capecitabine and Weekly Docetaxel for Metastatic Castrate Resistant Prostate Cancer Sergey Shikanov, Jie Song, Cassandra Royce, Hikmat Al-Ahmadie, Kevin Zorn, Gary Steinberg, Gregory Zagaja, Arieh Shalhav, and Scott Eggener Sergey ShikanovSergey Shikanov , Jie SongJie Song , Cassandra RoyceCassandra Royce , Hikmat Al-AhmadieHikmat Al-Ahmadie , Kevin ZornKevin Zorn , Gary SteinbergGary Steinberg , Gregory ZagajaGregory Zagaja , Arieh ShalhavArieh Shalhav , and Scott EggenerScott Eggener View All Author Informationhttps://doi.org/10.1016/j.juro.2009.02.139AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Length and location of positive surgical margins are independent predictors of biochemical recurrence after open radical prostatectomy. We assessed their impact on biochemical recurrence in a large robotic prostatectomy series. Materials and Methods: Data were collected prospectively from 1,398 men undergoing robotic radical prostatectomy for clinically localized prostate cancer from 2003 to 2008 at a single institution. The associations of preoperative prostate specific antigen, pathological Gleason score, pathological stage and positive surgical margin parameters (location, length and focality) with biochemical recurrence rate were evaluated. Margin status and length were measured by a single uropathologist. Biochemical recurrence was defined as serum prostate specific antigen greater than 0.1 ng/ml on 2 consecutive tests. Cox regression models were constructed to evaluate predictors of biochemical recurrence. Results: Of 1,398 consecutive patients who underwent robotic prostatectomy positive margins were present in 243 (17%) (11% of pathological T2 and 41% of T3). Preoperative prostate specific antigen, pathological stage, Gleason score, margin status, and margin length as a continuous and categorical variable (less than 1, 1 to 3, more than 3 mm) were independent predictors of biochemical recurrence. Patients with negative margins and those with a positive margin less than 1 mm had similar rates of biochemical recurrence (log rank test p = 0.18). Surgical margin location was not independently associated with biochemical recurrence. Conclusions: Margin status and length are independent predictors of biochemical recurrence following robotic radical prostatectomy. Although longer followup and validation studies are necessary for confirmation, patients with a positive margin less than 1 mm appear to have similar recurrence rates as those with negative margins. References 1 : Anatomic site-specific positive margins in organ-confined prostate cancer and its impact on outcome after radical prostatectomy. Urology1997; 50: 733. 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Crossref, Medline, Google Scholar University of Chicago, Chicago, Illinois© 2009 by American Urological AssociationFiguresReferencesRelatedDetailsCited byKates M, Sopko N, Han M, Partin A and Epstein J (2015) Importance of Reporting the Gleason Score at the Positive Surgical Margin Site: Analysis of 4,082 Consecutive Radical Prostatectomy CasesJournal of Urology, VOL. 195, NO. 2, (337-342), Online publication date: 1-Feb-2016.Udo K, Cronin A, Carlino L, Savage C, Maschino A, Al-Ahmadie H, Gopalan A, Tickoo S, Scardino P, Eastham J, Reuter V and Fine S (2012) Prognostic Impact of Subclassification of Radical Prostatectomy Positive Margins by Linear Extent and Gleason GradeJournal of Urology, VOL. 189, NO. 4, (1302-1307), Online publication date: 1-Apr-2013.Spahn M, Briganti A, Capitanio U, Kneitz B, Gontero P, Karnes J, Schubert M, Montorsi F, Scholz C, Bader P, van Poppel H and Joniau S (2012) Outcome Predictors of Radical Prostatectomy Followed by Adjuvant Androgen Deprivation in Patients with Clinical High Risk Prostate Cancer and pT3 Surgical Margin Positive DiseaseJournal of Urology, VOL. 188, NO. 1, (84-90), Online publication date: 1-Jul-2012.Budäus L, Isbarn H, Eichelberg C, Lughezzani G, Sun M, Perrotte P, Chun F, Salomon G, Steuber T, Köllermann J, Sauter G, Ahyai S, Zacharias M, Fisch M, Schlomm T, Haese A, Heinzer H, Huland H, Montorsi F, Graefen M and Karakiewicz P (2010) Biochemical Recurrence After Radical Prostatectomy: Multiplicative Interaction Between Surgical Margin Status and Pathological StageJournal of Urology, VOL. 184, NO. 4, (1341-1346), Online publication date: 1-Oct-2010.Related articlesJournal of Urology18 May 2009Phase II Trial of Capecitabine and Weekly Docetaxel for Metastatic Castrate Resistant Prostate Cancer Volume 182Issue 1July 2009Page: 139-144 Advertisement Copyright & Permissions© 2009 by American Urological AssociationKeywordsrecurrenceprostatectomyMetricsAuthor Information Sergey Shikanov Nothing to disclose. More articles by this author Jie Song Nothing to disclose. More articles by this author Cassandra Royce Nothing to disclose. More articles by this author Hikmat Al-Ahmadie Nothing to disclose. More articles by this author Kevin Zorn Financial interest and/or other relationship with Intuitive Surgical and SurgRx, Inc. More articles by this author Gary Steinberg Financial interest and/or other relationship with Vysis, Bioniche and Spectrum. More articles by this author Gregory Zagaja Financial interest and/or other relationship with Intuitive Surgical. More articles by this author Arieh Shalhav Nothing to disclose. More articles by this author Scott Eggener Nothing to disclose. More articles by this author Expand All Advertisement PDF downloadLoading ...