Positive margin length and highest Gleason grade of tumor at the margin predict for biochemical recurrence after radical prostatectomy in patients with organ-confined prostate cancer

Chapin, Brian F.; Nguyen, Joanne; Achim, Mary; Navai, Neema; Williams, Stephen B.; Prokhorova, Ina N.; Wang, Xuemei; Tapia, Elsa M. Li Ning; Davis, John W.; Troncoso, Patricia

doi:10.1038/s41391-017-0019-4

Cited by 35 publications

(35 citation statements)

References 31 publications

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“…10 We defined BCR as the finding of two PSA readings ≥0.05 ng/mL and demonstrating a rising trend. This is a lower threshold than used by other authors who stipulate, for example, levels of ≥0.2 ng/mL 12 35 43 or higher 37 before declaring BCR. We would typically refer patients fitting our definition for early salvage radiotherapy and therefore have defined BCR as such.…”

Section: Discussionmentioning

confidence: 90%

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Oncological Outcomes of Open Radical Retropubic Prostatectomy in Ireland: A Single Surgeon's 5-Year Experience

Croghan

Matanhelia

Foran

et al. 2018

Surg J

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Objectives There is a little published data on the outcomes of radical prostatectomy in the Irish context. We aimed to determine the 5-year oncological results of open radical retropubic prostatectomy (RRP) performed by a single surgeon following appointment. Methods A retrospective review of RRPs performed between 2011 and 2016 was conducted. Patient demographics, preoperative parameters (clinical stage on digital rectal exam, prostate-specific antigen (PSA) levels, biopsy Gleason's score and MRI [magnetic resonance imaging] findings), pathological variables (T-stage, Gleason's score, nodal status, and surgical margin status), and treatment decisions (lymphadenectomy or adjuvant radiotherapy) were recorded. Oncological outcome at last follow-up was ascertained. Results 265 patients underwent RRP between 2011 and 2016. Median age was 62 years (range: 41–74). Mean follow-up was 32.24 months (range: 8–72) months. Pathological disease stage was T2 in 170/265 (64.15%), T3a in 65/265 (24.53%), and T3b in 30/265 (11.32%). Final Gleason's score was upgraded from diagnostic biopsy in 16.35% (43/263) and downgraded in 27% (71/263). Pelvic lymph node dissection was performed in 44.25% (118/265) patients. A positive surgical margin (PSM) was seen in 26/170 (15.2%) patients with T2 disease and in 45/95 (47.37%) patients with T3 disease. Of the 265 patients, 238 (89.81%) were disease-free at last follow-up, of whom 24/238 (10.08%) had received adjuvant and 17/238 (7.14%) received salvage radiotherapy. Adjuvant/salvage treatment was ongoing in 19/265 (7.17%) of patients. Conclusion Good oncological outcomes of RRP in the Irish context are seen in this 5-year review, with the vast majority of patients experiencing biochemical-free survival at most recent follow-up.

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Section: Discussionmentioning

confidence: 90%

“…While follow-up is not yet adequate to draw definitive conclusions, we feel that PSMs alone should not prompt automatic administration of adjuvant therapy, and evidence from other experiences would support this. 43…”

Section: Discussionmentioning

confidence: 99%

Oncological Outcomes of Open Radical Retropubic Prostatectomy in Ireland: A Single Surgeon's 5-Year Experience

Croghan

Matanhelia

Foran

et al. 2018

Surg J

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“…Additionally, in case of multiple PSMs, data on length were available only for the longest margin, and this rendered the evaluation of cumulative PSM length unfeasible. Third, although other authors proposed that the Gleason score at the margin might be associated with an increased risk of recurrence [27][28][29], the lack of details on this parameter in our database prevented us from including this variable in our models. Fourth, the interobserver variability among uropathologists might represent a limitation to our study [30].…”

Section: Discussionmentioning

confidence: 97%

Defining Clinically Meaningful Positive Surgical Margins in Patients Undergoing Radical Prostatectomy for Localised Prostate Cancer

Martini

Gandaglia

Fossati

et al. 2021

European Urology Oncology

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“…To prevent over-tting and simpli cation, classi cation and regression tree (CART) analysis was used to identify relevant prognostic factors. The optimal cutoff points for signi cant prognostic factors were determined based on the optimal separation from a penalized discriminant analysis [21,22].…”

Section: Development Of the Models And Risk-scoring Toolsmentioning

confidence: 99%

Developing a scoring tool to estimate the risk of deterioration for normotensive patients with acute pulmonary embolism on admission

Gao

Zhao

et al. 2020

Preprint

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Background: It is important to identify deterioration in normotension patients with acute pulmonary embolism (PE). This study aimed to develop a tool for predicting deterioration among normotensive patients with acute PE on admission.Methods: Clinical, laboratory, and computed tomography parameters were retrospective collected for normotension patients with acute PE who were treated at a Chinese center from January 2011 to May 2020 on admission into hospital. The endpoint of the deterioration was any adverse outcome within 30 days. The eligible patients were randomized 2:1 to training and validation datasets. A nomogram was developed and validated by training and validation datasets respectively. The areas under the receiver operating characteristic curves (AUCs) and 95% confidence intervals (CIs) were calculated. A risk-scoring tool for predicting deterioration was applied as a web-based calculator.Results: The 845 eligible patients (420 men, 425 women) had an average age of 60.05±15.43 years. Adverse outcomes were identified for 81 patients (9.6%). The nomogram for adverse outcomes included heart rate, systolic pressure, N-terminal-pro brain natriuretic peptide, and ventricular/atrial diameter ratios at 4-chamber view, which provided AUC values of 0.925 in the training dataset (95% CI: 0.900–0.946, p<0.001) and 0.900 in the validation dataset (95% CI: 0.883–0.948, p<0.001). A risk-scoring tool was published as a web-based calculator (https://gaoyzcmu.shinyapps.io/APE9AD/).Conclusions: We developed a web-based scoring tool that may help predict deterioration in normotensive patients with acute PE.

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Positive margin length and highest Gleason grade of tumor at the margin predict for biochemical recurrence after radical prostatectomy in patients with organ-confined prostate cancer

Cited by 35 publications

References 31 publications

Oncological Outcomes of Open Radical Retropubic Prostatectomy in Ireland: A Single Surgeon's 5-Year Experience

Oncological Outcomes of Open Radical Retropubic Prostatectomy in Ireland: A Single Surgeon's 5-Year Experience

Defining Clinically Meaningful Positive Surgical Margins in Patients Undergoing Radical Prostatectomy for Localised Prostate Cancer

Developing a scoring tool to estimate the risk of deterioration for normotensive patients with acute pulmonary embolism on admission

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