Margin involvement at prostatectomy for clinically localized prostate cancer: Does a low-risk group exist?

A Recursive Partitioning Analysis Demonstrating Risk Subsets for 8-Year Biochemical Relapse After Margin-Positive Radical Prostatectomy Without Adjuvant Hormone or Radiation Therapy

“…The bRFS at 8 years of those with GG1 disease with cumulative margin 2 mm or less was historically comparable (92%) to those with negative margins. 6 , 19 Additionally, approximately 50% of patients with GG2 and positive margins experienced biochemical failure at 8 years. Although the findings from this study are unique in terms of population size and robust follow-up, they align with others observing that increasing ME, number of positive margins, and higher GS correlate with worse bRFS after prostatectomy.…”

“…Surgical margin involvement at radical prostatectomy (RP) for prostate cancer (PC) is a well-established high-risk feature for recurrence. 1 , 2 However, not all patients with involved surgical margins ultimately experience biochemical or clinical progression, 3 , 4 , 5 particularly those with focal involvement 6 or low-grade Gleason group (GG) 6 without other high-risk features (eg, seminal vesicle or lymph node involvement). 4 , 5 Randomized trials have suggested that adjuvant radiation therapy after RP may improve biochemical control and possibly survival for patients with pathologically advanced disease (inclusive of positive margins).…”

Recaída bioquímica en cáncer de próstata de bajo riesgo tratados con prostatectomía radical y linfadenectomía pélvica

“…En nuestro estudio, el 79% de los pacientes que recayeron eran R1, mientras que la invasión linfovascular solo estuvo presente en un 6%. 21 La principal limitación de nuestro estudio, se centra en la diferencia en el tiempo de seguimiento de los pacientes, debido a que al corresponder a un estudio retrospectivo la información disponible sobre el seguimiento de los pacientes es limitada y todos los pacientes no tienen el mismo tiempo de seguimiento para evaluar el desenlace, por esta razón, el estudio describe las diferencias encontradas al comparar los dos grupos (presencia o no de recaída bioquímica), que se aplican a la población de estudio y deben ser evaluadas como posibles factores asociados mediante futuros estudios analíticos y prospectivos. En relación a la calidad de los datos, se considera que las fuentes de información usadas (laboratorio y patología), son de alta calidad debido a procedimientos estandarizados usados en la práctica diaria.…”

What Is the Optimal Management of Gleason Score 7 Prostate Cancer at Biopsy? A Comparison of Disease Control for Prostatectomy Versus Radiotherapy

“…Certainly the present study supports this position, although longer follow-up will be necessary to determine whether this translates into survival end points. In addition, although presently the identification of subgroups within the high-risk postprostatectomy population remains to be validated, 14,15,17 retrospective studies demonstrate promising early disease control with salvage RT when initiated early (optimally peak postprostatectomy PSA < 0.5 ng/ mL). 18,19 Of note, within the present study population, 11 RP patients remained without evidence of disease after salvage RT, 7 of whom had PSA of < 0.5 ng/mL at the time of salvage therapy.…”